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Latest Quality Data Updated on CMS Hospital Compare

The following is a summary of the latest quality data updated on CMS Hospital Compare.  Data was updated on October 25, 2017.   As previously announced by CMS, the overall hospital quality star ratings was not updated on Hospital Compare in this October updated. CMS decided not to proceed with the October update to continue its examination of potential changes to the Star Rating methodology based on public feedback. The star ratings released last December will remain on the Hospital Compare website until the next update. 

1. Structural measures (7 measures)

  • 1 measure (ACS Registery) data updated to report data for reporting time period 15Q4_16Q3.
  • 6 measures (SS_SS_CHECK, SM-PART-NURSE, SM-PART-GEN-SURG, OP_25, OP_12, OP-17) data reporting time period remains unchanged reporting data through 15Q1_15Q4 (data is updated annually in December)
2. HCAPHS: (32 measures) data updated to report data through 16Q1_16Q4 

3.Timely & effective care: Cataract surgery outcome (1 measure)

  • 1 measure (OP-31) data reporting time period remains unchanged reporting data through 15Q1_15Q4 (data is updated annually in December)
4. Timely & effective care – Colonoscopy follow-up (2 measures)
  • 2 measures (OP-29, OP-30) data reporting time period remains unchanged reporting data through 15Q1_15Q4 (data is updated annually in December)
5. Timely & effective care: Heart Attack (4 measures)
  • 4 measures (OP-3b, OP-5, OP_4 OP_2) data updated to report data through 16Q1_16Q4
6. Timely & effective care – Emergency Department (8 measures)
  • 2 measures (EDV, OP-22) data reporting time period remains unchanged reporting data through 15Q1_15Q4 (data is updated annually in December)
  • 6 measures (ED-1b, ED-2b, OP-18b, OP-20, OP-21, OP-23) data updated to report data through 16Q1_16Q4
7. Timely & effective care – Preventive care (2 measures)
  • 1 measure (IMM-2) data reporting time period remains unchanged reporting data through 15Q4_16Q1 (data is updated annually in December)
  • 1 measure (IMM-3) data updated to report data through 16Q4_17Q1
8. Timely & effective care – Stroke care (1 measure)
  • 1 measure (STK-4) data updated to report data through 16Q1_16Q4
9. Timely & effective care – Blood clot prevention & treatment (2 measures)
  • 2 measures (VTE-6, VTE-5) data updated to report data through 16Q1_16Q4
10. Timely & effective care – Pregnancy & delivery care (1 measure)
  • 1 measure (PC-01) data updated to report data through 16Q1_16Q4
11. Complications – Surgical complications (11 measures)
  • 1 measure (COMP-HIP-KNEE) data reporting time period remains unchanged reporting data through 13Q2_16Q1 (data is updated annually in July)
  • 10 measures (PSI-90-SAFETY, PSI-3-ULCER, PSI-4-SURG-COMP, PSI-6-IAT-PTX, PSI-7-CVCBI, PSI-8-POST-HIP, PSI-12-POSTOP-PULMEMB-DVT, PSI-13-POST-SEPSIS, PSI-14-POSTOP-DEHIS, PSI-15-ACC-LAC) data reporting time period remains unchanged reporting data through 14Q3_15Q3 (data is updated annually in July)
12. Complications – HAI (6 measures)
  • 6 measures (HAI-1, HAI-2, HAI-3, HAI-4, HAI-5, HAI-6) data updated to report data through 16Q1_16Q4
13. Readmissions & deaths – 30 day rates of readmission (11 measures)
  • 9 measures (READM-30-COPD, READM-30-AMI, READM-30-HF, READM-30-PN, READM-30-STK, READM-30-CABG, READM-30-HIP-KNEE, EDAC-30-AMI, EDAC-30-HF) data reporting time period remains unchanged reporting data through 13Q3_16Q2 (data is updated annually in July)
  • 1 measure (READM-30-HOSP-WIDE) data reporting time period remains unchanged reporting data through 15Q3_16Q2 (data is updated annually in July)
  • 1 measure (MSPB-1)  data reporting time period remains unchanged reporting data through 15Q1_15Q4  (data is updated annually in December)
14. Readmissions & deaths – 30 day death rates (6 measures)
  • 6 measures (MORT-30-COPD, MORT-30-AMI, MORT-30-HF, MORT-30-PN, MORT-30-STK, MORT-30-CABG) reporting time period remains unchanged reporting data through 13Q3_16Q2 (data is updated annually in July)
15. Use of medical imaging – Outpatient imaging efficiency (6 measures)
  • 6 measures (OP-8, OP-9, OP-10, OP-11, OP-13, OP-14) data reporting time period remains unchanged reporting data through 15Q3_16Q2  (data is updated annually in July)
16. Payment & value of care (4 measure)
  • 3 measures (PAYM_30_AMI, PAYM_30_HF, PAYM_30_PN) data reporting time period remains unchanged reporting data through 13Q3_16Q2  (data is updated annually in July)
  • 1 measure (PAYM-90-HIP-KNEE) data reporting time period remains unchanged reporting data through 13Q2_16Q1

MEASURES AND CURRENT DATA COLLECTION PERIODS FOR VHA HOSPITALS

1. COMPLICATIONS – Surgical complications (12 measures – Updated quarterly (until 36 months of data) then updated annually in July)

  • 12 measures (PSI-4-SURG-COMP, PSI-6-IAT-PTX, PSI-7-CVCBI, PSI-8-POST-HIP, PSI-12-POSTOP-PULMEMB-DVT, PSI-13-POST-SEPSIS, PSI-14-POSTOP-DEHIS, PSI-15-ACC-LAC, PSI-3, PSI-9, PSI-10, PSI-11)  reporting data through 15Q4_17Q1

2. READMISSIONS & DEATHS – 30 day rates of readmission (4 measures)

  • 4 measures (READ-30-COPD, READM-30-AMI, READM-30-HF, READM-30-PN) reporting data through 12Q4_15Q3 (data updated annually in July)

3. READMISSIONS & DEATHS – 30-day death (mortality) rates (4 measures)

  • 4 measures (MORT-30-COPD, MORT-30-AMI, MORT-30-HF, MORT-30-PN) reporting data through 12Q4_15Q3 (data updated annually in July)