The Premier healthcare alliance, which lists 2,000 hospitals across the country as members, says quality reporting that requires proprietary information, tools or methodology is too expensive and sets a bad precedent.
Moreover, the alliance contends, such requirements would slow the uptake of electronic health records.
The alliance’s quality improvement committee sent a letter in June to the Centers for Medicare & Medicaid Services objecting to the inclusion of quality measures that require the use of proprietary standards in public reporting scheduled to occur in about a year.
The CEOs, representing 17 hospitals and healthcare systems comprising more than 100 hospitals, said government mandates requiring the the use of proprietary approaches from private organizations would create costly requirements for hospitals, slow the movement of electronic health records and create monopolistic pricing power for private vendors.
Premier sent a letter to the National Quality Forum opposing the use of any quality measures that depend on proprietary methodologies or tools as contrary to the public interest and evidence-based quality improvement.
The Charlotte, N.C.-based alliance specifically objected to the inclusion of 15 performance measures from the Society of Thoracic Surgeons’ National Cardiac Database. Those measures are among 43 quality measures that CMS is proposing to add to the hospital quality measure reporting program; hospitals will need to report results in fiscal year 2009, beginning October 1, to qualify for a full inflation update to their payments in fiscal 2010.
As of October 1, some 3,500 hospitals paid under the inpatient prospective payment system will need to report on 73 measures. The FY 2009 standards were endorsed by the National Quality Forum.
The approach opens a Pandora’s box for future adoption of quality measures because it sets the precedent that other proprietary standards could be required of hospitals by CMS, said Blair Childs, senior vice president of public affairs for Premier.
In the alliance’s view, information must be collected and reported in the same way for quality measures to be meaningful. The terms, format, calculations, submission, validation and other aspects of data collection and reporting must be in the public domain to optimize the comparability of data, the alliance said.
Many proprietary methodologies require significant manual abstraction of data and could force hospitals to hire additional dedicated staff for each measurement area, the alliance states.
“This is a step backwards for hospitals at precisely the same time they are moving forward with electronic quality reporting to improve efficiency,” said Charles Hart, MD, chairman of the Premier healthcare alliance’s quality improvement committee and CEO of Regional Health in South Dakota.” Continuing to ask hospitals to manually abstract more data, and for multiple vendors, adds a significant financial burden and diverts attention from the intent of data collection – looking for opportunities to improve care outcomes, patient safety and care delivery efficiency.”
Editor, Fred Bazzoli also contributed to this story