Measure Results by Hospital and Geographic Location

2020 Measure Reporting Year

Measurement Period: April 2016 - June 2019

Identifying geographic variation in hospital outcomes is important for improving the quality of care nationwide. Identifying geographic differences in relation to measure outcomes and hospital characteristics at the hospital-, state-, and census region-level helps provide context for policy-related decision making.

To begin exploring the data:

  1. Select up to 6 measures (the hospital-wide readmission measure is selected by default)

  2. Select desired hospital characteristics

  3. Select desired map view at the top right of the map; search for areas of interest at the top left 

The map displays average performance by color, with lighter color indicating better performance and darker color indicating worse performance. Average and individual measure performance data are shown when hovering over or clicking areas of the map. In the Region view, performance is ranked from 1 (best) to 4 (worst). In the Sub-region, State, and Hospital views, deciles [ranked groups from 1 (best) to 10 (worst)] are used.

Other Years

2020 2019 2018

Table View

Please note, for data to appear below, you must select at least one region, state, or hospital.

How This Is Calculated

Results at the Hospital Level: 

1. All hospitals are ranked in order of decreasing performance [lowest value (best performance) to highest value (worst performance)] for each measure.

2. The hospitals are divided into 10 equal groups based on their ranking for each measure.

 

If only one measure is selected, the results at this level will display which of the 10 groups the hospital was assigned to.

 

If multiple measures are selected, a simple average of the group assignments is calculated as follows:

 

 

 

Results at the State Level:

For each measure, all the hospitals within a state are averaged to get state level performance. This is done by taking the hospital performance multiplied by the number of patients seen at that hospital:

 

Then, a weighted average of all of the hospitals in the state is calculated:

 

Then for each measure the states are ranked and placed into deciles:

 

If only one measure is selected, the results at this level will display which of the 10 groups the state was assigned to.

 

If multiple measures are selected, a simple average of the group assignments is calculated as follows:

 

 

 

Results for the Subregion Level:

Similar to the results at the state level, to get results for the subregion level for each measure a weighted average of all of the hospitals in the subregion is calculated. Then for each measure the subregions are ranked and placed into deciles.

 

Results for the Region Level:

To get results for the region level for each measure, a weighted average of all the hospitals in the region is calculated. Then for each measure the regions are ranked 1 through 4. The ranks are averaged if multiple measures are selected.

Notes

For the publicly reported results by hospital, please visit Hospital Compare.

MEASUREMENT PERIOD

The measures included in this visualization have the following measurement period:

Table 1. Included Measures

Outcome 

Condition/Procedure

Measurement Period

Mortality

Acute Myocardial Infarction

7/2016 - 6/2019

Coronary Artery Bypass Graft Surgery

7/2016 - 6/2019

Chronic Obstructive Pulmonary Disease

7/2016 - 6/2019

Heart Failure

7/2016 - 6/2019

Pneumonia

7/2016 - 6/2019

Stroke

7/2016- 6/2019

Complication

Total hip arthroplasty and/or total knee arthroplasty

4/2016 - 3/2019

Readmission

Acute Myocardial Infarction

7/2016 - 6/2019

Coronary Artery Bypass Graft Surgery

7/2016 - 6/2019

Chronic Obstructive Pulmonary Disease

7/2016 - 6/2019

Heart Failure

7/2016 - 6/2019

Hospital-wide

7/2016 - 6/2019

Pneumonia

7/2016 - 6/2019

Total hip arthroplasty and/or total knee arthroplasty

7/2016 - 6/2019

Payment

Acute Myocardial Infarction

7/2016 - 6/2019

Heart Failure

7/2016 - 6/2019

Pneumonia

7/2016 - 6/2019

Total hip arthroplasty and/or total knee arthroplasty

4/2016 - 3/2019

Excess Days in Acute Care

Acute Myocardial Infarction

7/2016 - 6/2019

Heart Failure

7/2016 - 6/2019

Pneumonia

7/2016 - 6/2019

 

DATA NOTES

Only hospitals with at least 25 qualifying hospitalizations for a given measure are included in the visualization.

Beginning with the 2019 reporting year, the stroke readmission measure was removed from this data visualization because this measure is no longer reported in the Inpatient Quality Reporting Program (IQR). This measure’s results are still available in reporting years prior to 2019.

Additional data source(s) include:

2018 IPPS IMPACT file

DEFINITIONS

Table 2. Key Definitions

Term

Definition

Region

Census regions are groupings of states and the District of Columbia that subdivide the United States. There are four census regions: Midwest, Northeast, South, and West

Sub-region

Census sub-regions are groupings of states and the District of Columbia that further subdivide the census regions of the United States. There are nine census sub-regions: New England, Middle Atlantic, South Atlantic, East North Central, East South Central, West North Central, East North Central, Mountain, and Pacific

Decile

Ten equal groups into which a population can be divided per the distribution of values

Hospital population

The type of patient population that receives care at a hospital

Number of beds

The number of staffed beds available at a hospital

Rank

Position when units are ordered based on the distribution of values

Safety-net hospital

A hospital that provides a significant level of care to low income, uninsured, and patient populations with social risk factors

Teaching Hospital

A hospital or medical center that provides clinical education and training to future or current health professionals

 

Methodology Sources

AMI, COPD, Heart Failure, and Pneumonia Readmission Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Condition-Specific Measures Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Readmission Measures: Acute Myocardial Infarction – Version 13.0, Chronic Obstructive Pulmonary Disease – Version 9.0, Heart Failure – Version 13.0, Pneumonia – Version 13.0. https://qualitynet.cms.gov/files/609524402be51c001edf6195?filename=2020_Readmission_Meas_Updates_Specs.zip. Available as of Spring 2020.

 

CABG and Hip/Knee Arthroplasty Readmission Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Procedure-Specific Measures Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Readmission Measures: Isolated Coronary Artery Bypass Graft (CABG) Surgery – Version 7.0, Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) – Version 9.0. https://qualitynet.cms.gov/files/609524402be51c001edf6195?filename=2020_Readmission_Meas_Updates_Specs.zip. Available as of Spring 2020.

 

AMI, COPD, Heart Failure, Pneumonia, and Stroke Mortality Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Condition-Specific Measures Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Mortality Measures: Acute Myocardial Infarction – Version 14.0, Chronic Obstructive Pulmonary Disease – Version 9.0, Heart Failure – Version 14.0, Pneumonia – Version 14.0, Stroke – Version 9.0. https://qualitynet.cms.gov/files/607333022402a2001eb9e25d?filename=2020_Mort_Meas_UpdtsSpecsResrc.zip. Available as of Spring 2020.

 

CABG Mortality Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Procedure-Specific Measure Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Mortality Measure: Isolated Coronary Artery Bypass Graft (CABG) Surgery – Version 7.0. https://qualitynet.cms.gov/files/607333022402a2001eb9e25d?filename=2020_Mort_Meas_UpdtsSpecsResrc.zip. Available as of Spring 2020.

 

Hip/Knee Arthroplasty Complication Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Procedure-Specific Measure Updates and Specifications Report Hospital-Level Risk-Standardized Complication Measure: Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) – Version 9.0. https://qualitynet.cms.gov/files/60734125aba8620022335c08?filename=2020_THA_TKA%20Comp_MUS_Rpt.zip. Available as of Spring 2020.

 

AMI, Heart Failure, Pneumonia, and Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) Payment Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Measure Updates and Specifications Report Hospital-Level Risk-Standardized Payment Measures: Acute Myocardial Infarction – Version 9.0, Heart Failure – Version 7.0, Pneumonia – Version 7.0, Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) – Version 6.0. https://qualitynet.cms.gov/files/6092dd81fd340b002259fde6?filename=2020_Payment_AUS_Rprt.zip. Available as of Spring 2020.

 

AMI, Heart Failure, Pneumonia Excess Days in Acute Care Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 Condition-Specific Measures Updates and Specification Report Hospital-Level 30-Day Risk-Standardized Excess Days in Acute Care Measures: Acute Myocardial Infarction – Version 5.0, Heart Failure – Version 5.0, Pneumonia – Version 4.0. https://qualitynet.cms.gov/files/6092b1cdfd340b002259fdaf?filename=2020_EDAC_MeasMethRpt.pdf. Available as of Spring 2020.

 

Hospital-Wide Readmission Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2020 All-Cause Hospital-Wide Measure Updates and Specifications Report: Hospital-Level 30-Day Risk-Standardized Readmission Measure – Version 9.0 https://qualitynet.cms.gov/files/609524402be51c001edf6195?filename=2020_Readmission_Meas_Updates_Specs.zip. Available as of Spring 2020.

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