Texas above national average
30 percent, said David Thomsen, vice president of quality at St. David’s.
Hospital quality is judged on 12 items, including whether heart attack patients received medicine to prevent blood clots and whether patients who had surgery or pneumonia received the correct antibiotics. Satisfaction is gauged by patient responses to eight questions, including whether the staff communicated instructions well and how well pain was controlled.
Although public hospitals tend to do worse, the public University Medical Center Brackenridge, run by Seton, will receive a bonus for its patient quality and satisfaction scores.
Officials at both Seton and St. David’s said they strongly support the federal scoring program.
“It’s working, and it’s great for patients,” Thomsen said. “It’s created this wonderful dialogue across the country.”
The program will help consumers compare hospitals, said Lisa McGiffert, director of the Safe Patient Project for Consumers Union.
“What’s helpful to the public to know is the federal government, as per the health reform law, is giving bonuses for the hospitals that do well in their quality and safety measures and assessing penalties on hospitals doing poorly,” McGiffert said.
The government’s efforts to tie $1 billion in Medicare payments to patient quality and satisfaction come nearly three months after the Centers for Medicare and Medicaid Services began penalizing hospitals for readmitting patients within 30 days of discharge.
Twelve Austin-area hospitals, in a list dominated by Seton, received smaller Medicare payments starting Oct. 1 because of the rate of their readmissions.
Seton anticipates its losses on the latest quality and satisfaction measures, which will take effect New Year’s Day, to be “about half a million dollars,” spokeswoman Adrienne Lallo said.
That is not much for Seton, and the results were expected, she said, adding that Seton takes seriously the goal of the program: improving patient care. Seton has started programs that include calling dis- Austin Surgical Hospital Cedar Park Regional Medical Center Central Texas Medical Center, San Marcos St. David’s North Austin Medical Center St. David’s Round Rock Medical Center Scott & White Hospital-Round Rock Seton Northwest Hospital Seton Medical Center Austin Seton Medical Center Hays Seton Medical Center Williamson Seton Southwest Hospital St. David’s Medical Center* St. David’s South Austin Medical Cente The Hospital at Westlake Medical Center University Medical Center Brackenridge charged patients at home to remind them to take their medicine, and it has opened a clinic to give attention to congestive heart failure patients, Lallo said.
St. David’s probably will get “hundreds of thousands of dollars” in bonuses, Thomsen said, but amounts aren’t known because they are based on how many Medicare patients the hospitals treats between the beginning of the year and Sept. 30, he said.
Nationwide, Medicare judged 2,984 hospitals, including 251 in Texas, according to the Kaiser analysis. Texas hospitals did better than the national average, with 66 percent getting bonuses and 34 percent being penalized in comparison with a national average of 52 percent getting bonuses and 48 percent getting dinged, according to Kaiser.
The most any hospital could gain or lose is 1 percent of its Medicare payments, but those percentages will increase annually. For nearly two-thirds of the nation’s hospitals, the changes are less than a quarter of a percent of their payments, Kaiser said.
Central Texas Medical Center was disappointed by the results, although 0.39% -0.04% -0.08% 0.41% 0.26% 0.35% -0.01% -0.03% 0.35% 0.21% 0.22% 0.31% 0.33% 0.38% 0.18% the financial effect is minimal, said spokesman Clay DeStefano. “In the last year alone, CTMC received several quality achievement awards from a variety of sources on these very measures, which just shows how rapidly health care industry measures — especially those affecting reimbursements — are changing,” he said.
Cedar Park Regional Medical Center has taken various steps to improve patient care, said spokeswoman Laura Balla, including identifying patients at the highest risk for readmission and educating patients to better take care of themselves after they are discharged.
The Texas Department of State Health Services this month has posted hospital-acquired infection data for the first half of this year online at txhsn.dshs.texas.gov/hai for certain conditions, but most Central Texas hospitals’ performance was average or they did not have enough data to report.
The Kaiser analysis is available at kaiserhealthnews.org/Stories/2012/ December/21/medicarehospitals-value-basedpurchasing.aspx.