A new study published in The American Journal of Managed Care found that by using quality measures, CMS has encouraged hospitals to make quality improvement (QI) changes to improve clinical care and outcomes.
In this study, hospitals reported broad investments in QI changes, and most reported each change to be helpful. Furthermore, implementation of substantially more QI changes was associated with modestly better performance on CMS quality measures. Although QI changes were associated with improved clinical outcomes and patient experience, their strongest association was with clinical process measures. Given that CMS measurement programs for hospitals have shifted away from process measures toward outcomes of care, hospitals will need to identify QI changes that are more effective for improving outcomes. Analyses that identify the costs and benefits from individual QI actions or combinations thereof could help guide hospital investment of limited resources.
Researchers used data from the 2016 National Hospital Provider Survey, which they conducted for CMS as part of its 2018 National Impact Assessment of CMS Quality Measures. The survey assessed how hospitals were responding to CMS quality measurement, reporting, and payment initiatives. They identified 23 QI changes that they grouped into 7 categories: organizational culture, health information technology (IT), care process redesign, provider incentives, changes to staffing levels or responsibilities, performance monitoring, and measure-specific QI initiatives and technical assistance. The survey asked hospitals to report whether they had implemented any of the 23 potential QI changes to improve performance on CMS quality measures and whether the reported changes were perceived to be helpful in improving performance on the CMS measures. 1,313 acute care hospitals responded to the survey.
- Actions to Improve Quality: Results From a National Hospital Survey. The American Journal of Managed Care, December 2021.