Need Long-Term Care or Rehab? New Medicare Websites Can Help

From Health Care on Bloomberg Law

December 15, 2016

By Michael D. Williamson

Medicare beneficiaries and others can turn to two new government-run websites for quality information on inpatient rehabilitation facilities and long-term care hospitals.

The Inpatient Rehabilitation Facility (IRF) Compare and Long-Term Care Hospital (LTCH) Compare websites are live, Centers for Medicare & Medicaid Services officials said in a blog post Dec. 14.

Some other CMS quality reporting websites, such as Hospital Compare, now include overall star ratings for facilities that combine over 60 individual quality measures into a unified rating of one to five stars.

Star ratings prompted a bipartisan uproar in Congress when they were added to the Hospital Compare website earlier this year. It’s too early to tell if the CMS will create a similar star rating system for the IRF and LTCH websites, Akin Demehin, director of policy at the American Hospital Association (AHA), told Bloomberg BNA Dec. 14. The AHA is the largest hospital industry group in the U.S. and has offices in Washington and Chicago.

However, in a CMS regulation issued a year or two ago, the agency mentioned the possibility of star ratings for these facilities, Demehin said.

Fiscal year 2016 rules for the IRF and LTCH quality reporting programs stated the CMS will not use the five-star methodology until it has a sufficient number of quality metrics, an agency spokesperson told Bloomberg BNA Dec. 14.

Specific Measures

Medicare Compare websites for IRFs and LTCHs are required by law, Demehin said.

Key quality metrics, such as unplanned readmissions and the percentage of patients with new or worsened pressure ulcers, are displayed on the IRF and LTCH websites. Quality data on similar Medicare-run websites allow beneficiaries and other users to compare information about several providers against one another on the same page.

An industry group for teaching hospitals, the Association of American Medical Colleges (AAMC), wants one measure used on both sites—which assesses 30-day readmissions—to be risk-adjusted to account for a patient’s socioeconomic status, Scott Wetzel, the AAMC’s senior specialist of quality reporting, told Bloomberg BNA Dec. 14. Several social determinants of health are out of the provider’s control, and failure to make this adjustment disadvantages those IRFs and LTCHs that care for the most vulnerable patients, Wetzel said.

The AHA expects that CMS will add more measures to both sites in the future, Demehin said.

Doctor Quality Website

A separate, preexisting Medicare website, Physician Compare, is poised to include a larger, more diverse set of quality information for group practices, individual clinicians and accountable care organizations, the blog post said.

The information will help Medicare beneficiaries evaluate group practices and clinicians across a range of specialties. The aim is to help consumers and beneficiaries choose providers by making health-care quality information more transparent and understandable, Patrick Conway and Kate Goodrich wrote.

Conway is the acting principal deputy administrator and chief medical officer at the CMS. Goodrich serves as the director of the agency’s Center for Clinical Standards & Quality.

The CMS has been increasing the amount of data on the Physician Compare website for some time, and more information is expected to be added in the coming years, Demehin said.

However, the AHA strongly encourages the CMS to take a thoughtful approach to what data is reported and ultimately displayed on the Physician Compare website, Demehin said. In particular, the Medicare agency should focus on collecting data, adding that is the most probable way to increase outcomes, he said.

Though the AHA has some specific concerns about the provider reporting that is done to produce data for the Compare websites, it remains supportive of the CMS’s overall efforts to increase the transparency of quality data, Demehin told Bloomberg BNA.

Hospital Compare Changes

The CMS will also update the overall information on Hospital Compare to reflect refreshed measure data, Conway and Goodrich said. “This update includes a refresh of the Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS) data; five new oncology care measures that were added to the Prospective Payment System-Exempt Cancer Hospital Reporting Program; and the addition of a readmission after coronary artery bypass graft surgery measure to Hospital Readmission Reduction Program,” they wrote.

New data is uploaded to the Hospital Compare website quarterly, Demehin said, adding the latest updates are fairly routine.

The last quarterly update to the website, which occurred in October, didn’t alter the overall star ratings significantly, Demehin said.

Hundreds of lawmakers and several hospital industry groups urged the CMS to change the methodology used to calculate the star ratings on the Hospital Compare website when the agency unveiled the rating system in July. Despite those efforts, the CMS hasn’t really altered its measures in any significant way since star ratings were first released, Demehin said.

The current star ratings don’t accurately display hospital performance, Demehin said.

For example, he noted, some of more complex hospitals and academic medical centers are at a disadvantage under the current star rating system because they treat the sickest patients with the most complications and who may be more likely to be readmitted.

Hospitals with high readmission rates are likely to score lower on the CMS star ratings under the current system.

To contact the reporter on this story: Michael D. Williamson in Washington at mwilliamson@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

For More Information

The CMS blog post is at http://src.bna.com/kKf.

The IRF Compare website is at https://www.medicare.gov/inpatientrehabilitationfacilitycompare/.

The LTCH Compare website is at https://www.medicare.gov/longtermcarehospitalcompare/.

The Physician Compare website is at https://www.medicare.gov/physiciancompare/search.html.

Copyright © 2016 The Bureau of National Affairs, Inc. All Rights Reserved.


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