The Initiative is intended to (a) empower consumers with quality of care information to make more informed decisions about healthcare, and (b) encourage providers and clinicians to improve the quality of healthcare. The Hospital Inpatient Quality Reporting (IQR) Program requires . For example, the data currently collected comprises the following conditions: Acute Myocardial Infarction (AMI), Heart Failure (HF), Pneumonia (PN), Surgical Care Improvement Project (SCIP), Emergency Department (ED), Immunization (IMM), Healthcare Associated Infection (HAI), 3. Risk- Standardized Mortality and Readmission rates for AMI, HF and PN patients, Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSI) and Inpatient Quality Indicators (IQI) measures, AHRQ PSI and nursing sensitive measure, Hospital Acquired Conditions (HAC), structural measures that include Cardiac Surgery, Stroke Care and Nursing Sensitive Care, Data Accuracy and Completeness Acknowledgment (DACA) and the patients experience of care through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient survey. Hospitals must report quality measures of process, structure, outcome, and patients perspective on care, efficiency, and costs of care that relate to services furnished in an inpatient setting in order to receive the full Annual Payment Update (APU). Each fiscal year, a hospital s APU will be reduced by 2. Secretary. The information in this handbook describes how hospitals, paid by Medicare under the acute- care Inpatient Prospective Payment System (IPPS), can receive the full Medicare APU in accordance with the Deficit Reduction Act of 2. Section 1: Overview Page 3. Handbook Scope This handbook reviews only information applicable to the Hospital IQR Program. Additional Information After review of the Help Guide for questions or detailed guidance on a specific issue, contact the hospital s state QIO. QIOs may contact the program support contractor for assistance. For a list of QIO contacts, visit the Quality. Net website, https: //www. Glossary of Terms Acute Care Hospital - A hospital providing inpatient medical care and other related services for surgery, acute medical conditions or injuries (usually for a short term illness or condition). Annual Payment Update (APU) The annual market basket update for Medicare payments. The Hospital Inpatient Quality Reporting program was developed as a result of the Medicare. Hospital Quality Alliance (HQA) HQA Program Overview. Specifications Manual for National Hospital Inpatient Quality Measures. APU is the measure of inflation in costs of goods and services used by hospitals in treating Medicare patients. CMS Abstraction and Reporting Tool (CART) CMS tool for the collection, management, and analysis of quality improvement data. Critical Access Hospital (CAH) - A facility providing limited inpatient hospital services to people in rural areas. CMS Definition: A small facility that gives limited outpatient and inpatient services to people in rural areas. Data Accuracy and Completeness Acknowledgement (DACA) A requirement for Hospital IQR Program participating hospitals, DACA is an electronic acknowledgement indicating the data provided to meet the APU data submission requirements is accurate and complete to the best of the hospital's knowledge at the time of data submission. Components of the Specifications Manual for National Hospital Inpatient Quality Measures and the Specifications Manual for Joint Commission. Reporting Program Overview The Inpatient Psychiatric Facility Quality. National Quality Reporting Crosswalk for Critical Access Hospitals MBQIP Hospital Engagement. Hospital Inpatient Quality Reporting Program; Hospital Outpatient Quality Reporting Program; Hospital Compare; Hospital Compare Ads. Hospital Inpatient Quality Reporting Program. Overview of the Final IPPS Rule for FY 2016 The Final IPPS Rule for FY 2016 published in August brings many changes to Hospital Quality Reporting. During this complimentary. Hospital Inpatient Quality Reporting Program Eligible Provider - A subsection (d) hospital paid under the Inpatient Prospective Payment System (IPPS). Hospital Inpatient Quality Reporting Program Non- Eligible Provider - A hospital not considered to be a subsection (d) hospital or a hospital that is not paid under the IPPS. Hospital Inpatient Quality Reporting Program Quality Measures A comprehensive data set for health conditions common among people with Medicare and which typically result in hospitalization. Section 1: Overview Page 4. Proposed Rule and Final Rule Publication Site The IPPS rule publication can be accessed from the CMS website at http: //www. Select the link for the appropriate fiscal year. The Final Rule Home page has a list at the bottom of the page that centralizes any files related to the final rule and all subsequent published correction notices for the selected fiscal year. Select the appropriate link for the fiscal year rule. Section 1: Overview Page 5. Scroll to the bottom of the Final Rule Home Page section. CMS Hospital Inpatient Quality Reporting Program. Overview Page 3 CMS Hospital Inpatient Quality Re porting Program. The Hospital Inpatient Quality Reporting. Inpatient Quality Reporting Program. Short-Term Acute Care Hospital Quality Reporting (HQR) Programs Overview. Hospital Inpatient Quality Reporting (IQR) Program Hospital Inpatient Value, Incentives, and Quality. Value-Based Purchasing Program Overview Maida Soghikian, MD. Presentation Overview 2. Select either the Text Version link or the PDF Version link to download the document. The F on CMS- 1. 51. F represents Final and the CN represents Correction Notice. To locate the section specific to the Hospital IQR Program, refer to the rule publication news article located on Quality. Net (https: //www. Section 1: Overview Page 6. Section 2: Quality. Net Registration Refer to, Handbook I: Getting Started with Quality. Net - Section 2: Quality. Net Registration and Section 3: Quality. Net Requirements, for complete details on registration and requirements. To participate in the Hospital IQR Program and submit data for hospital reporting, hospitals register with My Quality. Net, the only CMS- approved website for secure healthcare quality data exchange. The Hospital IQR Program requires the hospital have at least one active Quality. Net Security Administrator. Best Practice: It is recommended hospitals designate a minimum of two Quality. Net Security Administrators - one to serve as the primary Quality. Net Security Administrator and the other to serve as backup. To keep the hospital s account active, it is recommended that the Quality. Net Security Administrator sign- in at least once a month. Section 2: Quality. Net Registration Page 7. Section 3: Notice of Participation To participate in the Hospital IQR Program, each hospital must complete a Notice of Participation through an online tool on My Quality. Net. A hospital that has indicated its intent to participate is considered an active participant and does not need to sign a new Notice of Participation, unless CMS determines a need for re- pledging or the hospital submits a Withdrawal through the online tool. New subsection (d) hospitals and existing hospitals participating in the Hospital IQR Program for the first time must use the online tool on My Quality. Net to complete an inpatient Notice of Participation. The hospital must also designate contacts and include the name and address of each hospital campus sharing the same CMS Certification Number (CCN). Hospitals that would like to participate in the Hospital IQR Program for the first time, or that previously withdrew from the program and would like to participate again, must submit to CMS a completed Notice of Participation by December 3. New hospitals with a Medicare Accept Date of 1. Notice of Participation on file, need to complete a Notice of Participation through the online tool on My Quality. Net no later than 1. Medicare Accept Date. Example: A Notice of Participation was signed 4/9/2. Given the 4/9/2. 01. Q1. 0 discharges. Refer to the Notice of Participation user guide located on Quality. Net for information on utilizing the Notice of Participation online tool. Section 3: Notice of Participation Page 8. The user guide can be found by accessing, www. Hospital Inpatient Quality Reporting Program from the . Select the Notice of Participation (IPledge) link. Section 3: Notice of Participation Page 9. Select the User Guide from the list of available resources. Section 3: Notice of Participation Page 1. Section 4: Submit Aggregate Population and Sample Size Counts Refer to, Handbook IV: Specifications Manual for National Hospital Inpatient Quality Measures, for specific information regarding sampling and sampling thresholds. On a quarterly basis, hospitals submit aggregate population and sample size counts for Medicare and non- medicare discharges for the topic areas that require chart abstracted data. Best Practice: Prior to the population and sampling submission deadline, verify population and sampling numbers in order to identify and correct discrepancies. Monitoring data submitted to the QIO Clinical Warehouse is important. Two reports located on My Quality. Net are helpful in monitoring population and sampling data: Initial Patient Population and Sampling Summary Report provides a summary of submitted initial patient population and sampling data for Medicare and Non- Medicare patients by quarter, measure set, and provider. QIO Clinical Warehouse Initial Patient Population Submission Report allows providers and/or vendors who are submitting data to confirm that the XML file with the initial patient population and sampling data was added or deleted, successfully accepted, and if not, indicates any errors related to rejection. The required user roles for Population and Sampling include: ICD Population Sampling Read role - Allows the user to view population and sampling information. ICD Population Sampling Update role - Allows the user to update population and sampling information. Required Role: ICD Population Sampling Read or Update Role Section 4: Submit Aggregate Population and Sample Size Counts Page 1. Section 5: Collect, Report, Submit Data Hospitals participating in the Hospital IQR Program must continuously collect and report data for each of the quality measures in the measure sets (topic areas) that require chart abstractions, specifically: AMI, HF, PN, SCIP, ED and IMM. Hospitals submit either a complete population of cases or a random sample for each of the measure sets covered by the quality measures. Hospitals must meet the sampling requirements for each discharge quarter. Hospitals are not required to sample; however, the hospital s initial patient population size must exceed the minimum number of cases per quarter for the measure set or the hospital must submit 1. Detailed information on data collection can be found in the Specifications Manual located on Quality. Net. Also, refer to, Handbook IV: Specifications Manual for National Hospital Inpatient Quality Measures, for specific information regarding collecting and submitting inpatient quality measures.
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