The Data Challenge

The Hospital Quality Initiative features two types of hospital quality information for consumers, including (1) quality measures of hospital care derived from clinical data and (2) information on patient perspectives on their hospital care.

Clinical Quality Measures

The Hospital Quality Initiative is more complex, and consists of more developmental parts than the Nursing Home Quality Initiative and Home Health Quality Initiative. For the previous initiatives, CMS had well-studied and validated clinical data sets and standardized data transmission infrastructure from which to draw a number of pertinent quality measures for public reporting. Hospitals do not have a similar comprehensive data set from which to develop the pertinent quality measures, nor are hospitals mandated to submit clinical performance data to CMS.

CMS has worked with The Joint Commission and the CMS Quality Improvement Organizations (QIOs) to align their hospital quality measures. CMS has also contracted with the National Quality Forum (NQF) to propose a consensus-derived set of hospital quality measures appropriate for public reporting. We selected 10 measures from the NQF consensus-derived set for several quality improvement efforts and an additional 24 measures from the set for a quality incentive demonstration (see components listed below). The CMS QIOs are providing technical assistance to hospitals in their data abstraction and submission.

Patient Perspectives on Care

Although many hospitals already collect information on their patients' satisfaction with care, there currently is no national standard for measuring and collecting such information that would allow consumers to compare patient perspectives at different hospitals. CMS is working with the Agency for Healthcare Research and Quality (AHRQ) to develop a standardized Hospital Patient Perspectives on Care Survey, known as HCAHPS. The HCAHPS survey will build on AHRQ's success in establishing surveys measuring patient perspectives on care in the United States health-care system through the development of CAHPS for health plans. The hospital patient perspectives data will be published to help consumers make more informed hospital choices, and to create incentives for hospitals to improve quality of care.