Results of Hospital Quality Data Reporting Are In

Nearly all hospitals who participated in the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) in 2008 will receive the full market basket update of 3.6 percent for 2009, according to the Centers for Medicare & Medicaid Services (CMS).

“We are extremely pleased to find that hospitals have responded so successfully to the new outpatient quality measure reporting program,” said CMS Acting Administrator Kerry Weems in a Jan. 8 press release. “The reporting program represents another major step toward value-based purchasing of health care services to ensure that patients with Medicare and the American taxpayers get the best outcomes for their health care dollars.”

Of the 3,339 participating hospitals, 3,313 or 99.3 percent fulfilled the HOP QDRP requirements. The full market basket conversion factor of $66.059 for 2009 resulted from a 3.6 percent increase update factor, the required wage index budget neutrality adjustment of about 1.0013, and the 0.02 percent adjustment of projected hospital outpatient prospective payment system (OPPS) spending for the difference in the pass-through.

The remaining 26 hospitals who didn’t meet the HOP QDRP requirements will receive a payment update reduced by 2.0 percentage points. The reduced market basket conversion factor is $64.784. The final 2009 reporting ratio is 0.981, calculated by dividing the reduced market basket conversion factor by the full market basket conversion factor.

Of the 26 hospitals to receive reduced payments, 18 failed to report quality data successfully and eight did not have a QualityNet administrator in place — two of the seven requirements hospitals must meet to participate in the HOP QDRP.

The HOP QDRP, mandated by the Tax Relief and Health Care Act of 2006 (TRHCA), began in 2008 and applies to all hospitals paid under the OPPS.

Hospitals participating in the program were required to report data on the following seven quality measures in 2008:

  1. Median time to fibrinolysis;
  2. Fibrinolytic therapy received within 20 minutes;
  3. Median time to transfer to another facility for acute coronary intervention;
  4. Aspirin at arrival;
  5. Median time to electrocardiogram (ECG);
  6. Timing of antibiotic probylaxis; and
  7. Prophylactic antibiotic selection for surgical patients.

The OPPS 2009 final rule added four imaging efficiency measures, requiring hospitals to successfully report on 11 measures in 2009 to receive the full payment update for 2010.

The four new HOP QDRP measures are:

  1. MRI lumbar spine for low back pain
  2. Mammography follow-up rates
  3. Abdomen computed tomography (CT) — use of contrast material
  4. Thorax CT — use of contrast material

The proposed HOP QDRP measure set for 2011 includes data reporting for cancer, emergency department throughput, diabetes, falls, depression, stroke and rehabilitation, osteoporosis, medication reconciliation, and respiratory.

You can find more information regarding the HOP QDRP on the CMS Web site.

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