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Medicare Tests New Quality Measure: Readmission Rates for Heart Failure


The Centers for Medicare & Medicaid Services (CMS) has wrapped up a test run of a new measure for readmission of heart failure patients as the federal agency tries to educate hospitals and hospitalists before formally including it as a quality metric in fiscal year 2018.

The trial concludes October 7, 2015, for the new claims-based measurement, excess days in acute care (EDAC) after hospitalization for heart failure. It captures the number of days within the 30-day postdischarge period that a patient spends in acute care following an index admission for heart failure. The measure will be included in CMS’ Hospital Inpatient Quality Reporting Program in fiscal year 2018, but the agency plans to publicly report hospitals’ results on Hospital Compare next year.

CMS hopes the new measure will help educate hospitals and hospitalists about 30-day postdischarge outcomes for patients with heart failure and provide a better understanding of what services are utilized, which could translate to better interventions. CMS spokesperson Alper Ozinal says that hospitalists currently get “little feedback about what happens to their patients after discharge.”

“CMS found substantial variation in utilization across hospitals, which suggests an opportunity for improvement in transitional care practices,” Ozinal says. “CMS anticipates that the measure will support hospital efforts to further optimize quality of care, particularly the quality of transitional care, by providing a more comprehensive picture of postdischarge events.”

The measure’s trial run, which began September 8, 2015, measured Medicare fee-for-service patients age 65 and older who were hospitalized with a principal discharge diagnosis of heart failure. The outcomes are risk-adjusted, taking into account age, sex, and comorbidities.

Once the results are calculated, CMS will post a report on the QualityNet website. Comments are welcome as CMS is expected to discuss whether tweaks are needed in the measure’s methodology.

Visit our website for more information on hospital readmissions.

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