CMS/Premier Hospital Quality Incentive Demonstration (HQID)
Model hospital value-based purchasing program continues to improve patient outcomes
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Hospitals participating in the Centers for Medicare & Medicaid Services (CMS), Premier healthcare alliance Hospital Quality Incentive Demonstration (HQID) VBP project raised their overall quality by an average of 17.2 percent over four years based on their delivery of more than 30 nationally standardized and widely accepted care measures to patients in the five clinical areas.
These improvements saved the lives of an estimated 4,700 heart attack patients in four years, according to a Premier analysis of mortality rates at hospitals participating in the project. The more than 1.5 million patients treated in five clinical areas at the 230 participating hospitals also received approximately 500,000 additional recommended evidence-based clinical quality measures, such as smoking cessation, discharge instructions and pneumococcal vaccination, during that same timeframe.
Additional research by Premier using the Hospital Compare dataset showed that, by March 2008, HQID participants scored on average 6.9 percentage points higher (94.64 percent to 87.36 percent) than non-participants on 19 performance measures used by Hospital Compare, the government's scorecard for hospital quality.
New payment model helps drive additional improvements
CMS extended the project for three additional years through September 2009
to test the effectiveness of new incentive models and ways to improve
patient care. Beginning with Year 4 results, participants are eligible to
receive the following awards:
- Attainment Award – Hospitals that attain or exceed the median level composite quality score (CQS) benchmark from two years prior will receive an incentive payment.
- Top Performer Award –The top 20 percent of hospitals in each clinical area will receive an additional incentive payment. This group will receive the Attainment Award as well.
- Improvement Award – Hospitals that attain median level performance and are among the top 20 percent of hospitals with the largest percentage quality improvements in each clinical area will receive an additional incentive payment.
The new payment model has shown to promote increased quality improvements in the project. Thirteen hospitals moved from the bottom to the top 20 percent of hospitals in one or more clinical areas, improving quality scores by an average 28.1 percentage points over four years.
Overall, under the project extension's new reimbursement model, CMS announced that it will award incentive payments of almost $12 million in Year 4 to 225 providers for top performance, as well as top improvement and for reaching a level of attainment, in the project's five clinical areas. Overall, 1,258 awards were given to these top providers in the fourth year of the project, a five-fold increase from previous years. Through the project's first four years, CMS has awarded more than $36.5 million to top providers.
Results from Year 3 (June 2008):
HQID Year 3 spanned the timeframe of Q4 2005 through Q3 2006.
- Press release
- Premier Facts Sheet (.pdf)
- Quality scores by decile (.pdf)
- List of hospitals in the top 50 percent by condition
Results from Year 2 (January 2007):
HQID Year 2 spanned the timeframe of Q4 2004 through Q3 2005.
- Quality scores by decile (.pdf)
- List of hospitals in the top 50 percent by condition
- Premier Hospital Quality Incentive Demonstration White paper for Year 2 Data (.pdf)
Results from Year 1:
HQID Year 1 spanned the timeframe of Q4 2003 through Q3 2004.