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Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance?
Am J Med Qual. 2017 May/Jun; 32(3):254-260.AJ

Abstract

In October 2014, the Centers for Medicare & Medicaid Services began reducing Medicare payments by 1% for the bottom performing quartile of hospitals under the Hospital-Acquired Condition Reduction Program (HACRP). A tight clustering of HACRP scores around the penalty threshold was observed resulting in 13.2% of hospitals being susceptible to a shift in penalty status related to single decile changes in the ranking of any one of the complication or infection measures used to compute the HACRP score. The HACRP score also was found to be significantly correlated with several hospital characteristics including hospital case mix index. This correlation was not confirmed when an alternative method of measuring hospital complication performance was used. The sensitivity of the HACRP penalties to small changes in performance and correlation of the HACRP score with hospital characteristics call into question the validity of the HACRP measure and method of risk adjustment.

Authors+Show Affiliations

1 3M Health Information Systems, Wallingford, CT.1 3M Health Information Systems, Wallingford, CT.1 3M Health Information Systems, Wallingford, CT.2 Yale University School of Medicine, New Haven, CT.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27037265

Citation

Fuller, Richard L., et al. "Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance?" American Journal of Medical Quality : the Official Journal of the American College of Medical Quality, vol. 32, no. 3, 2017, pp. 254-260.
Fuller RL, Goldfield NI, Averill RF, et al. Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance? Am J Med Qual. 2017;32(3):254-260.
Fuller, R. L., Goldfield, N. I., Averill, R. F., & Hughes, J. S. (2017). Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance? American Journal of Medical Quality : the Official Journal of the American College of Medical Quality, 32(3), 254-260. https://doi.org/10.1177/1062860616640883
Fuller RL, et al. Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance. Am J Med Qual. 2017 May/Jun;32(3):254-260. PubMed PMID: 27037265.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance? AU - Fuller,Richard L, AU - Goldfield,Norbert I, AU - Averill,Richard F, AU - Hughes,John S, Y1 - 2016/04/01/ PY - 2016/4/3/pubmed PY - 2018/3/13/medline PY - 2016/4/3/entrez KW - Medicare KW - hospital KW - hospital complications KW - quality improvement SP - 254 EP - 260 JF - American journal of medical quality : the official journal of the American College of Medical Quality JO - Am J Med Qual VL - 32 IS - 3 N2 - In October 2014, the Centers for Medicare & Medicaid Services began reducing Medicare payments by 1% for the bottom performing quartile of hospitals under the Hospital-Acquired Condition Reduction Program (HACRP). A tight clustering of HACRP scores around the penalty threshold was observed resulting in 13.2% of hospitals being susceptible to a shift in penalty status related to single decile changes in the ranking of any one of the complication or infection measures used to compute the HACRP score. The HACRP score also was found to be significantly correlated with several hospital characteristics including hospital case mix index. This correlation was not confirmed when an alternative method of measuring hospital complication performance was used. The sensitivity of the HACRP penalties to small changes in performance and correlation of the HACRP score with hospital characteristics call into question the validity of the HACRP measure and method of risk adjustment. SN - 1555-824X UR - https://www.unboundmedicine.com/medline/citation/27037265/Is_the_CMS_Hospital_Acquired_Condition_Reduction_Program_a_Valid_Measure_of_Hospital_Performance L2 - http://journals.sagepub.com/doi/full/10.1177/1062860616640883?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -