New Mexico's Health Quality Improvement Organization

Hospitals : Public Reporting: Hospital Quality Alliance (HQA) and Annual Payment Update (APU) Initiative

Hospital Quality Alliance (HQA)

The Hospital Quality Alliance, formerly the National Voluntary Hospital Reporting Initiative (NVHRI), is a joint effort initiated by the American Hospital Association (AHA), the Federation of American Hospitals and the Association of American Medical Colleges. The Centers for Medicare & Medicaid Services (CMS) and the Joint Commission are also partners in this process.

The HQA began with the public reporting of 10 quality measures related to treatment of acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN) patients. Beginning with January 2007 discharges, the HQA measure set has expanded to 24 quality measures, including five surgical care measures. The HQA has also added the public reporting of AMI, HF, and PN mortality measures and Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey data; these data will begin being publicly reported in the fall 2007. Hospitals voluntarily agree to have these measures reported publicly on the Hospital Compare Web site. This Web site is accessible to providers and consumers.

The HQA uses QualityNet and the Quality Improvement Organization (QIO) Clinical Warehouse to collect data on the quality measures.

To participate in the HQA, hospitals must complete the following steps:

Hospitals with ORYX^tm vendors authorize their vendors, through NMMRA, to transmit data to the QIO Clinical Warehouse
Hospitals without vendors use an approved abstraction tool such as the CMS Abstraction and Reporting Tool (CART) to collect data
Complete the AHA Quality Initiative pledge form
Register a QualityNet administrator and upload data to the QIO Clinical Warehouse via QualityNet

Read more about the AHA Quality Initiative.

See the New Mexico hospitals that have signed up for the voluntary public reporting initiative at the AHA Web site.

Reporting Hospital Quality Data for Annual Payment Update (APU)

With passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003, Congress provided a financial incentive for all prospective payment system (PPS) hospitals to voluntarily report quality of care information so that consumers can compare care and make better-informed decisions [Section 501(b)].

Under the resulting Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) initiative, hospitals submit data for specific quality measures for health conditions common among people with Medicare, and which typically result in hospitalization.

For fiscal year (FY) payment updates in 2005 and 2006, CMS has required PPS hospitals to continuously submit data regarding 10 quality measures for three medical conditions: acute myocardial infarction (AMI), heart failure (HF) and pneumonia. PPS hospitals that did not participate in the RHQDAPU initiative by reporting the required data by the established deadlines will received a 0.4 percentage point reduction in their APU from Medicare. On Aug. 1, 2006, CMS published an update to the RHQDAPU. For the FY2007 APU, CMS requires PPS hospitals to submit data on 21 quality measures for public reporting for four medical conditions: AMI, HF, pneumonia, and surgical infection. Click here to view a summary of the FY2007 rule. For the FY2008 APU, CMS has published another update and now requires PPS hospitals to submit data on 24 quality measures, mortality measures, and HCHAPS data. See the final rule for public reporting for FY2008 posted by CMS on Nov. 1, 2006.

NMMRA has developed two learning tools to help introduce existing and new staff to the RHQDAPU initiative. Reporting Core Measures gives a brief overview of the RHQDAPU initiative and its implications. The Art of Documentation provides a quick reference guide to properly document care provided to patients.

Compare the measures for which hospitals collect data for the HQA, APU, and other reporting intiatives. For additional information, read the CMS Fact Sheet on the RHQDAPU Initiative and the RHQDAPU Checklist.

Search for your CMS provider ID to see whether your hospital was eligible to receive the full annual payment update for fiscal year 2007.

For a schedule of public reporting requirements, click here.

For more information, see also: