The Centers for Medicare & Medicaid Services (CMS) is dedicated to ensuring transparency and empowering patients to make informed decisions about their healthcare. Through collaborative efforts with hospitals nationwide, CMS provides publicly accessible information on hospital quality performance via Hospital Compare, available on Care Compare on Medicare.gov, and the Provider Data Catalog. These resources are invaluable tools for individuals seeking to understand and compare the quality of care offered by different hospitals.
What is Hospital Compare?
Hospital Compare is a consumer-centric resource designed to present complex hospital performance data in an easily digestible and standardized format. This initiative aims to provide credible and consistent information about the quality of care delivered across the nation’s hospitals. The data available on Hospital Compare primarily focuses on Medicare-certified hospitals, including:
- Acute Care Hospitals
- Acute Care Veteran’s Hospitals
- Department of Defense Hospitals
- Critical Access Hospitals
- Children’s Hospitals
It’s important to note that participation in data submission is crucial for most short-term acute care hospitals. Non-participation can result in a reduction in their annual Medicare fee-for-service payment rate, highlighting the significance of these reporting programs: the Hospital Inpatient Quality Reporting (IQR) Program and the Hospital Outpatient Reporting (OQR) Program. These programs, established through legislative acts like the Medicare Modernization Act of 2003 and the Tax Relief and Health Care Act of 2006, underscore the long-standing commitment to public reporting in healthcare.
Key Quality Measures on Hospital Compare
Care Compare on Medicare.gov offers a comprehensive suite of quality measures, allowing users to assess various aspects of hospital performance:
- Process of Care Measures: These metrics evaluate whether hospitals deliver recommended treatments and care based on established guidelines and standards. They essentially measure adherence to best practices for specific conditions, presented as percentages or rates for easy comparison. This allows patients to see how hospitals stack up against state and national benchmarks in delivering proven treatments.
- Outcome Measures: Going beyond treatment delivery, outcome measures focus on the actual results of patient care. These measures reflect the impact of hospital services on patient health, such as mortality rates or readmission rates for specific conditions.
- Patient Experience of Care: Understanding patient perspectives is vital. Hospital Compare incorporates data from the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey. This national, standardized survey captures patient experiences during recent hospital stays, providing insights into patient satisfaction and the overall care experience.
- Efficiency and Coordination Measures: Beyond clinical care, Hospital Compare also provides data on:
- Imaging efficiency patterns
- Care transitions
- Emergency Department (ED) throughput efficiency
- Care coordination
- Patient safety
A Look at the History of Hospital Public Reporting
The journey towards transparent hospital quality reporting began with the inception of Hospital Compare. This website was the result of a collaboration between Medicare and the Hospital Quality Alliance (HQA). Established in December 2002, the HQA, a public-private partnership, was formed to champion hospital quality reporting. Its diverse membership included consumer groups, hospitals, healthcare providers, employers, accrediting bodies, and federal agencies, all united by the goal of empowering consumers and driving quality improvement within U.S. hospitals. Since its launch, Hospital Compare has continually expanded its scope, incorporating numerous new measures and areas of focus.
- 2005: The initial phase saw the introduction of a “starter set” of ten process of care measures. These focused on key areas like heart attack, heart failure, pneumonia, and surgical care, laying the foundation for standardized quality assessment.
- 2008: Patient experience entered the forefront with the integration of data from the HCAHPS survey. Simultaneously, CMS began reporting hospital 30-day mortality rates for critical conditions like heart attack, heart failure, and pneumonia, adding crucial outcome-based metrics.
- 2009: The scope broadened to include hospital outpatient facilities, incorporating data on outpatient imaging efficiency and emergency department and surgical process of care measures, reflecting the expanding landscape of hospital services.
- 2010: Readmission rates became a key focus with the addition of 30-day readmission measures for heart attack, heart failure, and pneumonia patients, highlighting the importance of post-discharge care and preventing recurrent hospitalizations.
- 2011: Hospital-Associated Infections (HAIs) came under scrutiny with the reporting of data from the National Healthcare Safety Network (NHSN). This expansion included measures for ICUs and other hospital wards, addressing a critical aspect of patient safety.
- 2012: The Hospital Readmissions Reduction Program data was added, further emphasizing the focus on reducing preventable readmissions and improving care transitions.
- 2013: The Hospital Value Based Purchasing program data was integrated, linking payment to quality performance and incentivizing hospitals to enhance patient care.
- 2015: To enhance user experience and simplify quality assessment, HCAHPS Star Ratings were introduced, aligning with the broader initiative to implement 5-star quality ratings across CMS Compare websites.
- 2016: The Overall Hospital Quality Star Rating was launched in July 2016, providing a consolidated summary of hospital quality. Data from Veterans Health Administration Hospitals was also reintroduced, expanding the scope of reported data.
- 2017: Department of Defense hospitals were included in Hospital Compare, further broadening the representation of healthcare providers in the public reporting system.
- 2020: A significant shift occurred as hospital data was integrated with data from other care settings, creating a unified platform for comparing hospitals, nursing homes, and more. The original Hospital Compare website was retired in this transition, centralizing access through Care Compare.
- 2023: Veterans Health Administration (VHA) hospitals became eligible for Overall Hospital Quality Star Ratings, ensuring consistent quality assessment across various hospital systems.
- 2023: The “Birthing-Friendly” designation was introduced, marked by a new icon next to hospital names. This recognition highlights hospitals meeting specific criteria for maternal care, providing targeted information for expectant mothers.
Today, Care Compare on Medicare.gov and the Provider Data Catalog offer access to over 150 hospital quality measures. CMS remains committed to continuous improvement, working with stakeholders to enhance these resources and empower individuals with the information they need to make informed healthcare choices.
