Mission in D.C.

The Hospitalist. 2007 December;2007(12):

December 1, 2007 | The Hospitalist

Last fall, two PPC members, Eric Howell, MD, from Maryland, and Greg Seymann, MD, from California, visited members of their congressional delegation on Capitol Hill. Dr. Howell is director of Collaborative Inpatient Medicine Service, Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore. Dr. Seymann is associate clinical professor, University of California, San Diego School of Medicine, Division of Hospital Medicine. During their meetings, Drs. Howell and Seymann voiced support for legislation to avert the Medicare cuts and discussed other elements of SHM’s quality-centered legislative agenda, emphasizing the role of hospitalists in improving the quality of care provided in America’s hospitals.

Hospital Medicine Fast Facts: 5 Steps to Develop a Dashboard

Distill key indicators into a dashboard: A dashboard is a summary document, usually one to two pages long, that displays the most important practice performance indicators. The dashboard can display the trends and whether performance meets the target for each indicator.
Decide what to measure: Consider these questions: What were drivers for developing the program? What does the hospital expect for its support? What do stakeholders want to know about the program? What are priorities?
Set targets: Targets can be expressed as a threshold, such as “at least 85% Pneumovax (pneumococcal vaccine polyvalent) compliance” or an ideal range, such as “case mix-adjusted average length of stay between 3.2 and 4.0 days.”
Generate and analyze reports: The practice must know where to obtain the necessary data and understand how data are collected and reported to be confident in the degree of accuracy and validity.
Develop an action plan: Have a specific action plan for how the performance monitoring information will be used. The summary dashboard will be used to make decisions, improve performance, and demonstrate value. Consider the following: With whom will this information be shared? What specific steps should be taken to improve performance for individual metrics? How will decisions be made about performance improvement priorities and resource allocation? How will this information be used to help further the interests of the hospital medicine practice?

Download SHM’s dashboard white paper “Measuring Hospitalist Performance: Metrics, Reports, and Dashboards.” Visit the “SHM Initiatives” section at www.hospitalmedicine.org.

Hospital Payment (Part A)

SHM joined the American Hospital Association in opposition to a provision in the fiscal year 2008 Medicare inpatient prospective payment system, a proposed rule that would have cut Medicare payment for hospital services in fiscal year 2008.

The Centers for Medicare and Medicaid Services (CMS) sought to reduce hospital payments by 2.4% in 2008 and 2009 based on the assumption that hospitals will adjust coding practices to receive higher payments as a result of proposed changes in the payment system designed to account more fully for patients’ severity of illness.

This proposed “behavioral offset” would have cut $24 billion over five years from payments to hospitals. Congress enacted legislation in September that significantly reduces the cuts hospitals face in the next two years.

Quality Reporting

Together with the Performance and Standards Task Force (PSTF), PPC and staff have posted educational material on our Web site and made other resources available to SHM members to help them determine whether or not they should participate in the PQRI, which began July 1.

For example, SHM sponsored a nationwide call with CMS on the “Nuts and Bolts of Applying the PQRI to Your Hospital Medicine Practice.” Staff have since surveyed the SHM members who participated in this members-only call to learn more about what led them to participate or not to participate in the program. Those participating were asked for information on their experiences to help inform our policy on the initiative.