An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Data


  •  What data collection, data management, reporting infrastructure, and data outreach were required to implement existing P4P programs (e.g., sampling methodology, storage capacity)?
  •  How do current P4P programs address data collection issues, including sampling and minimizing burden, such as                   
    •  The alignment process with JCAHO (including warehouse edits and abstraction tool skip patterns) so that there continues to be a single abstraction of quality data for hospitals to receive their accreditation and CMS quality data payment. 
    •  Modifying reporting deadlines to better facilitate continuous quality data submission for concurrent abstraction hospitals. 
    •  Evaluating sampling requirements to ensure reliable data while minimizing burden. 
    •  The use of composite measures                    
  •  How can the lag from date of service to public reporting be minimized?
  •  What plans are there for receiving data directly from electronic health records (EHRs)?
  •  How should the data be safeguarded?
  •  How are data security and privacy issues balanced with restricted access to clinical warehouse data for analysis and modeling?
  •  What roles are currently served by and envisioned for various tools, including CART (the Quality Improvement Organization’s [QIO’s] Clinical Abstracting and Reporting Tool) and QnetExchange (the QIO data portal)?
  •  What access is required/envisioned for QIO data?
  •  How do the confidentiality requirements associated with data reported to CMS QIOs affect the uses to which hospital data reported for P4P can be put? Can the DHHS/CMS share this data with other payers, and can the data of other payers be integrated into the data set or calculation of rates? What entity controls access to and use of the data?
  •  How should the validation for P4P be structured to maximize effectiveness while minimizing costs? How should validation methodology assure abstraction reliability, adherence to sampling methodology, and submission completeness? How will measure-specific characteristics, such as relative variability in measure rates by hospital, be incorporated into validation sample sizes?

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