Hospital Measure Results Agreement

2021 Measure Reporting Year

Measurement Period: April 2017 - June 2020

Examine how consistently hospitals perform on pairs of outcome measures. For example, do hospitals that have low risk-standardized mortality rates for pneumonia tend to have low risk-standardized mortality rates for heart failure as well? Consistency is shown by the calculated level of agreement between an individual hospital's relative results on two selected outcomes measures.

To begin exploring the data:

  1. Click on a circle to compare within outcomes or across outcomes.
  2. Select one reference condition/procedure.
  3. Toggle between quartiles, quintiles, deciles or performance categories to increase or decrease the levels of agreement. 
  4. View the results as a pie chart for broad resuts or as a scatterplot for more detail.

 

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Compare within or across outcomes

Compare within outcomes:

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Compare across outcomes:

Current Characteristics:

  • {[{summary}]}
Filter by Hospital Characteristics
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{[{selectedOptionPrettyLongLabel}]}
View:
{[{selectedOptionPrettyLabel}]}
{[{selectedOptionPrettyLongLabel}]}
View:

{[{primaryMeasure.label ? primaryMeasure.label : referenceMeasureLabel}]} {[{primaryMeasure.label.length > 25 ? "(" + primaryMeasure.short_name + ")" : "" }]} {[{primaryMeasure.short_desc | lowercase}]}

High Agreement Low
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How do we determine agreement?

{[{primaryMeasure.label ? primaryMeasure.label : referenceMeasureLabel}]} {[{primaryMeasure.label.length > 25 ? "(" + primaryMeasure.short_name + ")" : "" }]} {[{primaryMeasure.short_desc | lowercase}]}

High Agreement Low
Empty
How do we determine agreement?

{[{primaryMeasure.label}]} {[{primaryMeasure.short_desc}]} vs. {[{compare.label}]} {[{compare.short_desc}]}

Levels of Agreement of Hospital Measure Results

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Scatterplot of Hospital Measure Results

Table View

{[{selectedOptionPrettyLabel}]} Total hospitals Same {[{quantile}]} {[{$index}]} {[{ $index > 1 ? quantiles : quantile}]}
difference
{[{primaryMeasure.short_name}]} {[{compType === "across" ? primaryMeasure.short_desc : ""}]} / {[{compare.short_name}]} {[{compType === "across" ? compare.short_desc : ""}]} {[{compare.calculated.total_hospitals}]} {[{ (bucket / compare.calculated.total_hospitals * 100) | number:0 }]}%
({[{bucket}]} )

Years:

2023 2022 2021 2020 2019 2018

How Do We Determine Agreement

For Quartiles, Quintiles, and Deciles

1. All hospitals are ranked in order of decreasing performance on the selected reference measure.
2. The hospitals are divided into groups based on their ranking.

  • 4 groups for quartiles, 5 groups for quintiles, 10 groups for deciles

 

The hospitals are divided into groups based on their ranking

3. Steps 1 and 2 are repeated for all measures being compared to the reference measure.

  • Within outcomes, the reference measure is compared to all other measures that have the same outcome (for example, AMI mortality compared to all other mortality measures)

  • Across outcomes selection, the reference measure is compared to measures with different outcomes but the same condition (for example, AMI mortality vs. AMI payment)

 

Steps 1 and 2 are repeated for all measures being compared to the reference measure

 
4. For any combination of two measures, the level of agreement for each hospital on the two measures is determined by the difference in the hospital’s group ranking (quartile, quintile, or decile number) for the two measures.
 

For any combination of two measures, the level of agreement for each hospital on the two measures is determined by the difference in the hospital’s group ranking (quartile, quintile, or decile number) for the two measures.

5. On the scatterplot, the hospitals are displayed in clusters that corresponds to their measure results and group rankings.
 

On the scatterplot, the hospitals are displayed in clusters that corresponds to their measure results and group rankings.

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

7/2019 - 6/2022

Coronary Artery Bypass Graft Surgery

7/2019 - 6/2022

Chronic Obstructive Pulmonary Disease

7/2019 - 6/2022

Heart Failure

7/2019 - 6/2022

Pneumonia

7/2019 - 6/2022

Stroke

7/2019 - 6/2022

Complication

Total hip arthroplasty and/or total knee arthroplasty

4/2019 - 3/2022

Readmission

Acute Myocardial Infarction

7/2019 - 6/2022

Coronary Artery Bypass Graft Surgery

7/2019 - 6/2022

Chronic Obstructive Pulmonary Disease

7/2019 - 6/2022

Heart Failure

7/2019 - 6/2022

Hospital-wide

7/2019 - 6/2022

Pneumonia

7/2019 - 6/2022

Total hip arthroplasty and/or total knee arthroplasty

7/2019 - 6/2022

Payment

Acute Myocardial Infarction

7/2019 - 6/2022

Heart Failure

7/2019 - 6/2022

Pneumonia

7/2019 - 6/2022

Total hip arthroplasty and/or total knee arthroplasty

4/2019 - 3/2022

Excess Days in Acute Care

Acute Myocardial Infarction

7/2019 - 6/2022

Heart Failure

7/2019 - 6/2022

Pneumonia

7/2019 - 6/2022
 
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.

DEFINITIONS

Table 2. Key Definitions

Term

Definition

Within Outcomes

Comparison of different conditions within a specified outcome (ex. AMI mortality vs. Heart failure mortality)

Across Outcomes

Comparison of the same condition (with the same cohort of patients) across different outcomes (ex. AMI mortality vs. AMI payment)

Quartiles

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

Quintiles

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

Reference Measure

Measure of interest or measure used to compare to all remaining measures with the same outcome

Scatterplot

A scatterplot is used to display values for two variables in a set of data. Scatterplots are used to examine how much one variable is affected by another.

Performance categories

To categorize hospital performance, hospitals are classified based on their risk-standardized rate and the associated 95% interval estimate as:
- No Different than the National Rate
- Worse than the National Rate
- Better than the National Rate

Payment "performance" categories

To categorize hospital payment results, hospitals are classified based on their risk-standardized payment and the associated 95% interval estimate as:
- No Different than the National Payment
- Less than the National Payment
- Greater than the National Payment
 

Methodology Sources

AMI, COPD, Heart Failure, and Pneumonia Readmission Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2023 Condition-Specific Measures Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Readmission Measures: Acute Myocardial Infarction – Version 16.0, Chronic Obstructive Pulmonary Disease – Version 12.0, Heart Failure – Version 16.0, Pneumonia – Version 16.0. https://qualitynet.cms.gov/inpatient/measures/readmission/resources Available as of Spring 2023.

 

CABG and Hip/Knee Arthroplasty Readmission Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2023 Procedure-Specific Measures Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Readmission Measures: Isolated Coronary Artery Bypass Graft (CABG) Surgery – Version 10.0, Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) – Version 12.0. https://qualitynet.cms.gov/inpatient/measures/readmission/methodology  Available as of Spring 2023.

 

AMI, COPD, Heart Failure, Pneumonia, and Stroke Mortality Measures Methodology: DeBuhr J, McDowell K, Grady J, et al. 2023 Condition-Specific Measures Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Mortality Measures: Acute Myocardial Infarction – Version 17.0, Chronic Obstructive Pulmonary Disease – Version 12.0, Heart Failure – Version 17.0, Pneumonia – Version 17.0, Stroke – Version 12.0. https://qualitynet.cms.gov/inpatient/measures/mortality/resources.  Available as of Spring 2023.

 

CABG Mortality Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2023 Procedure-Specific Measure Updates and Specifications Report Hospital-Level 30-Day Risk-Standardized Mortality Measure: Isolated Coronary Artery Bypass Graft (CABG) Surgery – Version 10.0. https://qualitynet.cms.gov/inpatient/measures/mortality/methodology. Available as of Spring 2023.

 

Hip/Knee Arthroplasty Complication Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2023 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 12.0. https://qualitynet.cms.gov/inpatient/measures/complication/resources Available as of Spring 2023.

 

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. 2023 Measure Updates and Specifications Report Hospital-Level Risk-Standardized Payment Measures: Acute Myocardial Infarction – Version 12.0, Heart Failure – Version 10.0, Pneumonia – Version 10.0, Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) – Version 9.0. https://qualitynet.cms.gov/inpatient/measures/payment/resources Available as of Spring 2023.

 

AMI, Heart Failure, Pneumonia Excess Days in Acute Care Measure Methodology: DeBuhr J, McDowell K, Grady J, et al. 2023 Condition-Specific Measures Updates and Specification Report Hospital-Level 30-Day Risk-Standardized Excess Days in Acute Care Measures: Acute Myocardial Infarction – Version 8.0, Heart Failure – Version 8.0, Pneumonia – Version 7.0. https://qualitynet.cms.gov/inpatient/measures/edac/resources Available as of Spring 2023.

 

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 12.0 https://qualitynet.cms.gov/inpatient/measures/readmission/methodology Available as of Spring 2023.

 

 

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