January 27, 2004

In thinking about Arkansas hospital participation in the national voluntary “Quality Initiative, a Public Resource on Hospital Performance,” we're reminded of an old spiritual: “Get on Board, Little Children – There's Room for Many a' More!” And not only room – there may be dire financial consequences for those hospitals choosing not to participate.

The Medicare Prescription Drug, Improvement, and Modernization Act passed in late 2003 provides a substantial financial incentive for participation: it provides a full market basket update for hospitals submitting data for the set of quality indicators that are the starting point of the Initiative. On the flip side, acute care hospitals choosing to opt out of the voluntary reporting will receive less than the full market basket update in FY 2005 and 2006 – 0.4% less, to be exact. 

Market basket updates of 0.4% less than inflation could hold very serious financial consequences for your hospital. Depending upon your hospital's annual number of Medicare admissions (and a variety of other factors in the reimbursement formula), the loss could range from $25,000 upward – way upward. Whatever the dollar total, can your hospital afford to lose already scarce Medicare funds by looking the other way?

Currently, 35 of Arkansas' 85 eligible acute care hospitals are participating in the Initiative. That's right at 41%, leaving about 59% of our hospitals at risk for losing out on the full market basket update. We hope you will seriously consider the consequences of non-participation. Can you really afford not to participate?

You remember The Quality Initiative. Proposed just more than a year ago by a coalition led by the American Hospital Association, the Federation of American Hospitals, and the Association of American Medical Colleges, the Quality Initiative is a national movement in which hospitals voluntarily report quality data on 10 nationally agreed-upon measures in the areas of acute heart attack, pneumonia, and congestive heart failure.

The information is then made available on a CMS Web site, www.cms.hhs.gov, and is intended to allow healthcare professionals to search for hospitals by state, county, or city to compare hospital performance on quality measures.

More quality measures will be added as time passes. The goal is to create additional measures based on the Institute of Medicine's priority areas, including diabetes, pregnancy and childbirth, and depression. Currently, national voluntary participation stands at 60%.

We here at the AHA urge hospitals to share quality of care information with the people they serve. As we have said before, voluntary reporting of quality data is simply the right thing to do. It builds goodwill with our communities and with the patients who choose to trust their healthcare to us. Participation in the voluntary reporting shows patients and their families that Arkansas' hospitals are determined to deliver the best care available, and that they proudly stand by that care.

Voluntary participation has other benefits, as well. It keeps the reporting of quality data voluntary, as opposed to being nationally mandated with a whole new set of rules and regulations. It also keeps us in the driver's seat when it comes to new, CMS-driven quality regulations. By being an active partner in the voluntary reporting system, hospitals assure their national hospital associations a seat at the table when discussions regarding healthcare quality take place. It's always better to be in on designing new regulations and initiatives; by doing so we can bring healthcare's real world perspective to the table and keep the discussions realistic.

As we begin a new calendar year, let us resolve to achieve 100% participation by Arkansas' acute care hospitals in the national quality initiative. Let us now “Get on Board, Little Children,” for the benefits are many, and in Arkansas, there's room for many a' more!