Administrative Memos

200006

FROM: Theodore O. Will, Chief Executive Officer
DATE: Oct 26, 2000
SUBJECT: Medicare Baseline Quality Performance Findings
IPRO CONTACTS:

Mary E. Hibberd, M.D., M.P.H., Senior Vice President, Medical Affairs, Ext. 563
Terri Straub, R.N., M.B.A., Senior Director, Improvement Strategies/Quality, Ext. 634

Attached please find the HCFA article "Quality of Medical Care Delivered to Medicare Beneficiaries; A Profile at State and National Levels" published in the October 4 edition of the Journal of the American Medical Association (JAMA). The information about the quality of care that Medicare beneficiaries received in 1997-1999 was based on 24 mostly inpatient, process-of-care measures derived from medical record reviews, claims information and survey data in six targeted clinical areas. These include management of acute myocardial infarction, breast cancer, diabetes, heart failure, pneumonia and stroke.

New York achieved an overall ranking of 31st in the state-by-state comparison. These are nationwide baseline findings. While our state was ranked in the middle range for a number of indicators, the data indicate obvious opportunities for improvement in certain areas. Under HCFA's "Sixth Scope of Work," IPRO and Peer Review Organizations (PROs) in all 50 states have been directed to collaborate with local hospitals and provider groups to improve performance. Enclosed is a graphic summarizing New York's performance on all 24 indicators.

Since the inception of the Sixth Scope of Work in August 1999, IPRO has been active in implementing educational programs for providers and consumers throughout New York State. This includes free CME programs for physicians and nurses and resource "tool kits" which are available on our website (www.ipro.org). We have just added the Diabetes Resource Guide and the Cardiac Toolkit, which providers may download from our site. We have distributed a community acquired pneumonia data collection CD-ROM to all New York State hospitals.

IPRO continues to meet one-on-one with the hospitals across the state to review individual performance data. In addition, IPRO works with the hospital associations throughout New York State to assist them in enhancing member hospitals' performance. Together, with the hospital associations, we are planning a series of Town Meetings to discuss the article. We are also in the process of developing hospital profiles highlighting performance of the 50-60 high-volume hospitals for each of the inpatient indicators.

I urge you to review the attached materials with your clinical staff in order to assure that programs are in place to improve upon the statewide baseline findings. HCFA will begin requesting a sample of medical records for remeasurement in 2001 to ascertain if there has been measurable improvement in these quality indicators. As always, IPRO's performance improvement staff is available to go to any hospital to provide technical support to assist your institution in improving performance rates.

Should you have any questions or need further information, please feel free to call Mary E. Hibberd, M.D., M.P.H., Senior Vice President, Medical Affairs at 516-326-7767 extension 563 or Terri Straub, R.N., M.B.A., Senior Director, Improvement Strategies/Quality at extension 634.