IHA Daily Briefing: Feb. 28

CMS Updates Quality Data & Star Ratings
IHA Releases Updated MACRA QPP Workbook Tool
Register for the IMEC Conference March 27

CMS Updates Quality Data & Star Ratings
Today, the Centers for Medicare & Medicaid Services (CMS) updated hospital performance data on its Hospital Compare website for the following Medicare quality-based programs: Value-Based Purchasing (VBP), Readmissions Reduction (RR), Hospital-Acquired Conditions (HACs) and the star ratings. The performance periods upon which the updated data are based vary depending upon the specific program, but generally run from the latter part of 2014 through the early part of 2018.

Earlier this month, AHA and other national groups urged CMS to postpone the February publication of its Overall Hospital Quality Star Ratings due to numerous concerns with its star ratings methodology.

There are star ratings for 163 hospitals in Illinois. Following is the star breakdown:

  • 12 hospitals received five stars;
  • 49 hospitals received four stars;
  • 55 hospitals received three stars;
  • 31 hospitals received two stars;
  • 16 hospitals received one star.

Hospitals received their own individual results from CMS through their confidential Quality Net account.

Members should be prepared to address calls from the media. In addition to talking about your hospital’s performance improvement activities and initiatives, feel free to customize these talking points related to the star ratings:

  • Patients and their families should use all available tools and resources to make healthcare decisions, including talking with friends, doctors and other healthcare providers and professionals;
  • There are various organizations besides CMS that provide reports and rankings of hospital performance and should be collectively taken into consideration; and
  • The star rating program is confusing and its methodology has been criticized by quality experts and Congress as being inaccurate and misleading to consumers.

Also today, CMS posted potential changes to the Hospital Star Ratings for public comment. CMS said that these changes under consideration are intended to respond to stakeholder feedback, seek to enhance the Star Ratings methodology by making hospital comparisons more precise and consistent, and allow more direct, “like-to-like” comparisons. One potential change, recommended by some hospitals, would place hospitals with similar characteristics into “peer groups” allowing, for example, small hospitals to be compared to other small hospitals instead of all hospitals. Comments are due March 29.


IHA Releases Updated MACRA QPP Workbook Tool
Today, IHA made available to its member CEOs, CFOs, CMOs and other finance staff on its website (password required) its third version of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 Quality Payment Program (QPP) workbook tool. This version incorporates calendar year 2019 revisions to the QPP and the Medicare Physicians Fee Schedule (PFS) final rule, as published in the Nov. 23, 2018 Federal Register, and includes illustrations of various payment scenarios for the four Illinois Medicare Part B regions: Chicago, Suburban Chicago, East St. Louis and the rest of Illinois.

Other components of the workbook include:

  • A three-year summary table of the PFS and QPP final rules;
  • 2019, 2018 and 2017 Medicare Physician Fee Schedule payment calculations for sample procedures;
  • A listing of medical and anesthesia procedure codes and Relative Value Units (RVUs) for input references;
  • A listing of the geographic adjustment factors for all regions in the U.S.;
  • 2017 Transition Year, Pick Your Pace options;
  • A glossary; and
  • An Input Table, in which members can enter specific procedure, volume and Medicare RVU data.

Members are encouraged to review the workbook and offer questions, comments or any suggestions for improvement.


Register for the IMEC Conference March 27
Join IHA at the IMEC Conference on Enterprise Excellence on March 27 from 8:30 a.m. to 4:30 p.m. at the Northern Illinois Conference Center in Naperville. IMEC, the sponsor, is the Illinois affiliate of the national Baldrige Performance Excellence Program, providing statewide education based on the Baldrige Excellence Framework and sharing best-in-class strategies for improving organizational practices.

During this one-day conference, you will hear from recognized leaders across all industries, who have led their teams and organizations to high performance in the areas of leadership, strategy, customer engagement, operations, workforce and technology. The 2019 conference features four quality award recipients, including HSHS St. Anthony’s Memorial Hospital – Effingham, who will receive the Bronze Award for Commitment to Excellence.  Eden Taksh, M.D., chief quality officer, Saint Anthony Hospital of Chicago, is a presenter along with IHA President and CEO A.J. Wilhelmi.

For more information and to register, click here.