Background On The Quality Initiative

In the spring of 2003, a group of national health care organizations initiated a voluntary program for measuring hospital quality, now known as the Hospital Quality Initiative.

Part of a comprehensive strategy to improve quality of care in the hospital setting, the Initiative is a collaborative effort of the American Hospital Association (AHA), the Centers for Medicare and Medicaid Services(CMS), the Agency for Healthcare Research and Quality (AHRQ), the Joint Commission for the Accreditation of Healthcare Organizations(JCAHO), and other national health care, consumer, and union organizations.

In Washington State, WSHA is actively working with Qualis Health, Washington's Quality Improvement Organization (QIO) and local CMS contractor, on the Hospital Quality Initiative.

The Initiative currently measures quality for three clinical areas: heart attack, congestive heart failure, and pneumonia. After hospitals have an opportunity to review the data they have submitted through the Initiative, the results are made available by CMS on Medicare's website.

The goals of the Initiative are: to create a common data set of quality information; to demonstrate a commitment on the part of hospitals and health care organizations to quality patient care; to share information among hospitals, health care providers and with the public about recognized quality indicators; to stimulate quality improvement; and to empower consumers to make informed decisions about their own health care.

Go to the CMS Hospital Quality Initiative Website

Quality Initiative Talking Points by AHA (Adobe Acrobat required)

WSHA Board Resolution

In May of 2003, the WSHA Board passed a resolution endorsing the Hospital Quality Initiative, and stating that hospitals would not use the data from the Initiative for competitive marketing purposes.

WSHA Webcast: Quality Initiative: Ensuring Success in Washington State

This webcast, presented in February 2004, was an introduction to the Quality Initiative. WSHA and Qualis Health will sponsor another webcast in February or March 2005 to prepare for the national public launch.

WSHA Webcast: Quality Initiative: Preparing for Public Reporting

WSHA Webcast: Quality and Reimbursement Now Linked: New Medicare Rule and the Impact Quality Reporting Will Have on Payment

The proposed Medicare inpatiend payment rule expands the number of measures that need to be submitted from ten to twenty-one, including measures for surgical infection.  If hospitals do not provide the expanded data set, they could lose two percent of their Medicare payments.  The validity of the hospital's abstraction process will also become critical to maintaining full Medicare payment.  This web conference addresses the requrements in the Medicare rule for prospective payment, the criteria for getting the full payments, and what the abstraction validity reports mean.  It also addresses what you should be expecting from your data vendors now and in the future in order to meet these requirements.