The Centers for Medicare & Medicaid Services (CMS) is committed to enhancing healthcare transparency through publicly accessible data. In line with this mission, CMS and hospitals across the nation collaborate to present comprehensive hospital quality performance information via user-friendly platforms like Care Compare on Medicare.gov and the Provider Data Catalog. These resources function as vital Comparative Health Care Systems Tools, designed to empower patients, providers, and researchers with the insights needed to make informed decisions and drive healthcare improvements.
Care Compare meticulously compiles hospital performance data, presenting it in a standardized and easily understandable format. This ensures that reliable information regarding the quality of care delivered across U.S. hospitals is readily available to the public. The hospitals featured on Care Compare primarily include Acute Care Hospitals, Acute Care Veteran’s Hospitals, Department of Defense Hospitals, Critical Access Hospitals, and Children’s Hospitals. It’s important to note that Care Compare exclusively incorporates data from Medicare-certified hospitals. A significant portion of participating institutions are short-term acute care hospitals. These hospitals are incentivized to participate through the Hospital Inpatient Quality Reporting (IQR) Program and the Hospital Outpatient Quality Reporting (OQR) Program, which can impact their Medicare fee-for-service payment rates based on data submission and compliance. The Hospital IQR Program, established by the Medicare Modernization Act of 2003 and expanded by the Deficit Reduction Act of 2005, and the Hospital OQR Program, mandated by the Tax Relief and Health Care Act of 2006, underscore the legislative commitment to data-driven healthcare quality improvement.
Care Compare on Medicare.gov offers a wealth of quality measures, enabling users to effectively utilize this comparative health care systems tool. Key data points include:
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Process of Care Measures: These measures evaluate whether healthcare providers adhere to recommended care guidelines and standards of practice. They assess the delivery of treatments known to yield optimal outcomes for patients with specific conditions. By converting medical record information into performance rates, these measures allow for a direct comparison of provider performance at the state and national levels.
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Outcome Measures: Focusing on the results of care, rather than just the interventions performed, outcome measures provide critical insights into the effectiveness of hospital treatments and procedures.
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Patient Experience of Care: The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey, a national standardized survey, captures patient perspectives on their recent inpatient hospital stays. This provides valuable qualitative data on patient satisfaction and the overall care experience.
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Efficiency and Coordination Metrics: Beyond traditional quality measures, Care Compare also incorporates data on imaging efficiency patterns, care transitions, emergency department throughput, care coordination, and patient safety. These metrics offer a more holistic view of hospital performance and operational effectiveness.
A Journey Through Hospital Public Reporting
CMS’s dedication to public reporting of hospital quality data began with Hospital Compare, a website developed through a collaboration between Medicare and the Hospital Quality Alliance (HQA). Established in December 2002, the HQA, a public-private partnership known as “Improving Care Through Information,” aimed to promote transparency in hospital quality of care reporting. This alliance included diverse stakeholders representing consumers, hospitals, providers, employers, accrediting bodies, and federal agencies, all united by the goal of empowering consumers with information for informed healthcare choices and supporting nationwide hospital quality improvements. Since its inception, public reporting sites have continuously expanded, incorporating numerous new measures and topics.
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2005: The initial phase saw the introduction of a “Ten measure “starter set” (PDF)” focusing on process of care measures for critical conditions like heart attack, heart failure, pneumonia, and surgical care.
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2008: Patient experience data from the (HCAHPS) survey, also known as the CAHPS Hospital Survey, was integrated into Hospital Compare. HCAHPS brought a standardized approach to measuring patient perspectives. Furthermore, CMS initiated reporting on hospital 30-day mortality rates for heart attack, heart failure, and pneumonia, adding crucial outcome-based metrics.
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2009: The scope expanded to include hospital outpatient facilities, incorporating outpatient imaging efficiency data along with emergency department and surgical process of care measures, broadening the comparative health care systems tool‘s reach.
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2010: 30-day readmission measures for heart attack, heart failure, and pneumonia patients were added, providing further insights into the longer-term effectiveness of hospital care and contributing to the comprehensiveness of the comparative health care systems tool.
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2011: Data on Hospital Associated Infections (HAIs) from the National Healthcare Safety Network (NHNS) began to be reported, encompassing ICUs and other hospital wards, enhancing patient safety information available through these comparative health care systems tools.
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2012: Data from the Hospital Readmissions Reduction Program was incorporated, further emphasizing CMS’s focus on reducing preventable readmissions and improving overall care quality.
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2013: The Hospital Value Based Purchasing program data was added, linking payment incentives to hospital performance and promoting value-based care delivery.
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2015: HCAHPS Star Ratings were introduced as part of a broader initiative to implement 5-star quality ratings across CMS Compare websites, simplifying quality assessment for consumers.
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2016: The Overall Hospital Quality Star Rating was launched in July 2016, and data from Veterans Health Administration Hospitals was reintroduced, expanding the scope and inclusivity of the comparative health care systems tool.
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2017: Data on Department of Defense hospitals was added to Hospital Compare, further enhancing the comprehensiveness of publicly reported hospital data.
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2020: Hospital data was integrated with data from other care settings, enabling users to compare hospitals, nursing homes, and more on a unified platform. The original Hospital Compare website was retired, streamlining access through Care Compare.
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2023: Veterans Health Administration (VHA) hospitals became eligible for Overall Hospital Quality Star Ratings, ensuring consistent quality assessment across various hospital systems. Furthermore, a “Birthing-Friendly” icon was introduced to recognize hospitals meeting specific criteria for maternal care, providing targeted information for expectant mothers.
Today, CMS reports over 150 hospital quality measures on Care Compare on Medicare.gov and the Provider Data Catalog. These platforms stand as crucial comparative health care systems tools, continuously evolving to provide increasingly valuable data. CMS remains dedicated to ongoing website improvement and collaboration with stakeholders to further enhance healthcare transparency and quality across the nation.
