Briefing: Health care quality
Earlier this month, the Center for Health Information and Analysis (CHIA) released its inaugural report measuring the performance of the Massachusetts health care system between 2011 and 2013, with a focus on provider quality. The report is meant to provide a baseline for annual reporting, CHIA said.
The report measured quality in acute care, primary care and post-acute care, and found that performance on many measures falls in line with national rates, though “there are large differences between the highest and lowest scores received by providers on some measures, suggesting variation in provider quality.”
How do hospitals, or acute-care providers, rate?
The report notes that after the federal Centers for Medicare and Medicaid (CMS) began offering incentives to hospitals for reporting data on quality measures, hospital quality in many areas has improved and disparities between state and national performances have narrowed. This may be why Massachusetts hospitals' performance on 16 clinical processes was “strong and virtually the same as national performance.”
According to CHIA data, Massachusetts hospitals are becoming safer. Scores that measure the rate of procedural and post-surgical complications in acute-care hospitals fell from 0.92 to 0.74 (the lower the score, the better), below the U.S. mean of 1.
What about readmissions?
Here, the hospitals have work to do. With 80 percent of acute care hospitals hit with CMS penalties for “excessive unplanned readmissions” last year, the Bay State is the fourth most penalized state, the report said. CHIA suggested that proper planning and changes in delivery of care, such as extending after-hours ambulatory care services, may help cut the rates. The national mean for Medicare patients from 2011 to 2012 was 16 percent, according to data cited by CHIA. Rates at 28 of the 63 Massachusetts hospitals analyzed were higher.
And what about primary care?
Experts often point to a primary-care physician shortage as a key hindrance to quality care. That's highlighted in the report, which includes survey data on patient experiences with physicians. Organizational access, which gauges satisfaction in appointment scheduling, received a score of 81 out of 100, the lowest among six measures. Patients were most satisfied with the quality of communication with doctors (94). That was followed by willingness to recommend their providers to others (91).
How about post-acute care?
While CHIA called home health care a “convenient, lower-cost alternative to care in a hospital or nursing home,” the high cost of skilled nursing facilities in Massachusetts was cited as a major factor in the industry's high per-capita spending; in 2009, costs at those facilities' were 74 percent higher than the national average, CHIA reported.
WBJ Web Partners
Most Recent
Most Recent
0 Comments