CMS Quality Improvement Activities Future of Healthcare in the Insular Areas A Leaders Summit September 29 30, 2008
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1 CMS Quality Improvement Activities Future of Healthcare in the Insular Areas A Leaders Summit September 29 30, 2008 Mary Rydell CMS Region IX Pacific Area Representative San Francisco, Honolulu 1
2 Topics HHS Value Driven Health Care Medicare Hospital Compare Quality Improvement Organizations State Survey Agency Survey & Certification Activities Stay Informed 2
3 Centers for Medicare & Medicaid Services (CMS) Administer the Medicare, Medicaid & State Childrens Health Insurance programs Represent about 33% of the health insurance market CMS programs % of the Federal budget spending; $517.3B in 2006 Monitor the health and safety of the providers that serve Medicare and Medicaid beneficiaries 3
4 Four Cornerstones to Value Driven Health Care I. Interoperable Health Information Technology (Health IT Standards) II. Measure and Publish Quality Information (Quality Standards) III. Measure and Publish Price Information (Price Standards) IV. Promote Quality and Efficiency of Care (Incentives) 4
5 Why Value Based Purchasing? Medicare Solvency and Beneficiary Impact Expenditures up from $219 billion in 2000 to a projected $486 billion in 2009 Part A Trust Fund Excess of expenditures over tax income in 2007 Projected to be depleted by 2019 Part B Trust Fund Expenditures increasing 11% per year over the last 6 years Medicare premiums, deductibles, and costsharing are projected to consume 28% of the average beneficiaries Social Security check in
6 Workers per Medicare Beneficiary 200 Selected Years in millions Covered Workers Part A enrollment 0 Worker to Beneficiary Ratio Source: OACT CMS and SSA 6
7 Under Current Law, Medicare Will Place An Unprecedented Strain on the Federal Budget 12% Historical Estimated 9% Total expenditures HI deficit Percentage of GDP 6% 3% State transfers General revenue transfers Premiums 0% Tax on benefits Payroll taxes Source: 2008 Trustees Report Calendar year 7
8 Medicare Hospital Compare 8
9 Hospital Compare CMS is posting volume and cost information which is a part of the Four Cornerstones- to measure and publish quality and price information. The information on Hospital Compare provides a general overview of hospitals performance and Medicare payment. Anyone considering where to get hospital care can compare hospitals using this information. According to the American Hospital Association s 2006 annual survey, there are 5,747 hospitals in the U.S. As of August 2008, information on 4,486 hospitals could be viewed on Hospital Compare based on both HCAHPS and clinical measure data. 9
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14 Sample Graph 1: Percent of Surgery Patients Who Received Preventative Antibiotic(s) One Hour Before Incision 14
15 Sample Graph 2: Percent of Heart Attack Patients Given Beta Blocker at Arrival 15
16 Sample Graph 3: Percent of Heart Failure Patients Given Discharge Instructions 16
17 Sample Graph 4: Pneumonia 30-Day Mortality 17
18 Quality Improvement Organizations 18
19 Quality Improvement Organization (QIO) Mountain Pacific Quality Health Foundation here in Honolulu QIO is a group of practicing doctors and other health care professionals paid by CMS to monitor the quality of care Involvement in QI activities, quality measure reporting with hospitals, NFs, HHAs and physicians Handle Medicare beneficiary quality of care complaints LBJ Tropical Medical Center 2 HHAs in Saipan, CNMI 19
20 ESRD Network 17 Western Pacific Renal Network in CA Contracted with CMS to improve the quality and safety of dialysis related services provided for individuals with ESRD Improve the independence, quality of life, and rehabilitation of individuals through transplantation, use of self-care modalities (e.g., PD, home hemodialysis), and in-center self-care Handle patient's complaints and grievances. Collaboration with providers to ensure achievement of the goals Improve the collection, reliability, timeliness, and use of data to measure processes of care and outcomes; maintain Patient Registry 20
21 State Survey Agency Survey & Certification Activities 21
22 State Survey Agency Survey & Certification Activities Hawaii Department of Health, Office of Healthcare Assurance Non-accredited hospitals are surveyed every 3 years Reviewed to ensure the facilities meet Medicare conditions of participation (COP). Different provider types have different time frames and COPs/standards Survey data used in Medicare.gov Nursing Home Compare and other comparison tools Technical assistance to providers provided through plan of corrections, re-survey process and Federal comparative surveys 22
23 Stay Informed- Resources CMS People with Medicare and public Hospital Compare State Survey Agency Mountain Pacific Quality Health Foundation QIO ESRD Network
24 Stay Informed- Region IX Stakeholder Call Every 3 rd Thursday of the month, 2-3pm PST Next call October 16, 2008 at 2 pm PST. Toll Free: Pass Code: Stakeholder Call Leader: David Saÿen Register for CMS Region IX Stakeholder ListServ for notification and details about calls, please contact: nicole.lockey@cms.hhs.gov 24
25 Mahalo! Mary Rydell CMS Region IX Pacific Area Representative Centers for Medicare & Medicaid Services Box Honolulu, HI (808)
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