Lesson - Uses of Standard Performance Measures

  • Objective Benchmarking Performance Measures are criteria and methods for deriving numeric quantifications of various objective peer-to-peer comparisons and rankings of healthcare activities and outcomes for HCPs and HCOs.
    • Transparency/Public Reporting: Currently Medicare Compare Programs report on:
      • Hospitals: Unfortunately, these programs are based on a limited portfolio of measures. In addition to the limited types of measures, there are lots of exemptions and exceptions for which providers should or are reported on, most notably, the exclusion of low-volume performing providers.  However, experts could argue that low-volume performing providers are exactly who we should be reporting on given the associations between low volumes and increased mortality and complication rates.
      • Nursing Facilities
      • Home Health Agencies
    • Pay-For-Performance: Currently Medicare Compare Programs include:
      • Hospital Readmission Reduction Program
      • Hospital Value-Based Purchasing: Includes measures:
        • 30-day Risk-Standardized Mortality Rates (RSMRs)
        • 30-day Risk-Standardized Readmission Rates (RSRRs)
        • AHRQ’s Inpatient Safety Indicators (IQI)
        • AHRQ’s Patient Safety Indicators (PSI)
        • Hospital Acquired Condition (HAC)
      • Medicare Shared Savings Program
    • Bundled Payments For Care Initiatives (BPCI) Pay-For-Performance: Currently Medicare Compare Programs compare hospitals, nursing homes, home health agencies, dialysis centers, health and drug plans based on a limited portfolio of measures.
    • Performance measures can be calculated Risk Adjustment – The process of controlling or accounting for patient-related factors before examining outcomes of care, regardless of context. (Iezzoni) (Generally, process performance measures are not risk-adjusted.)

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