US Centers for Medicare & Medicaid Services award $750K as part of national pay-for-performance project

GREAT NECK, NY – The US Centers for Medicare & Medicaid Services (CMS) has awarded nine North Shore-LIJ Health System hospitals more than $750,000 as part of a national pay-for-performance (P4P) demonstration project, including more than $200,000 to North Shore University Hospital (NSUH) in Manhasset, NY, the highest payment to any of the nation’s 247 medical institutions participating in the program this year.

The CMS/Premier healthcare alliance Hospital Quality Incentive Demonstration (HQID) P4P – also referred to as value-based purchasing - project is designed to determine if economic incentives to hospitals are effective at improving the quality of inpatient care. As part of the demonstration, CMS and Premier are collecting a set of more than 30 nationally standardized, evidence-based clinical quality measures from participating hospitals across the country.  Based on their performance in five clinical categories, nine North Shore-LIJ hospitals were rewarded with a total of  $767,067 in incentives, including an individual award of $226,938 to North Shore University Hospital.

The P4P model included financial incentives for the top 20 percent of hospitals in each of the five clinical areas: acute myocardial infarction (AMI); coronary artery bypass graft (CABG); heart failure (HF); community-acquired pneumonia (CAP); and hip and knee replacement (HNK). On average, the project raised overall quality in those clinical areas by 17.2 percent over four years at participating hospitals.

“As one of the largest healthcare providers in the New York metropolitan area, North Shore-LIJ Health System is proud that every one of our nine hospitals participating in this pay-for-performance project won an award in at least two categories,” said Michael J. Dowling, the health system’s president and chief executive officer. “North Shore University Hospital and LIJ Medical Center received eight awards each, including the highest individual reimbursement of any participating hospital this year.  Staten Island University Hospital won nine awards with at least one in each clinical area. Our goal is to instill that same commitment to quality standards at each and every one of our facilities across the system.”

According to an analysis of mortality rates among participating hospitals, improvements made as a result of the HQID project have saved the lives of an estimated 4,700 heart attack patients in four years. The more than 1.5 million patients treated also received approximately 500,000 additional recommended evidence-based clinical quality measures, such as smoking cessation counseling, comprehensive discharge instructions and pneumococcal vaccination, during that same time frame.

Individual facility performance measures for each disease category are aggregated into a composite score that is used to establish baseline performance and relative distribution of hospital participants. Awards are then distributed among a payment incentive model that recognizes:
• hospitals that exceed the median-level composite quality score benchmark from two years prior;
• hospitals that rank in the top 20 percent in each clinical area; and
• hospitals that attain median-level performance and are among the top 20 percent with the largest percentage quality improvements in each clinical area.

Additional data research by Premier showed that by March 2008, HQID participants scored on average 6.9 percentage points higher (94.6 percent to 87.4 percent) than non-participants on 19 performance measures used by “Hospital Compare,” the federal government’s scorecard for hospital quality. The hospital quality of care information gathered through the initiative is available to consumers on the Hospital Compare website at http://www.hospitalcompare.hhs.gov.

“As evidenced by the national debate over healthcare reform, there’s an emerging model of care in which patient outcomes will be tied to reimbursement,” said Kenneth J. Abrams, MD, North Shore-LIJ’s senior vice president of clinical operations and chief quality officer. “As healthcare providers, we have a responsibility to make sure that patient care continues to improve nationwide. The HQID project is a rewarding step toward that national improvement.” For complete information about the HQID project and to view a list of those hospitals ranking in the top 50 percent in each focus areas, visit www.cms.hhs.gov/HospitalQualityInits.

Media Contacts:Kristen Longo/Terry Lynam
516-465-2607/516-465-2640
klongo@nshs.edu/tlynam@nshs.edu