Medicare Hospital Quality Chartbooks (located on CMS website; see Downloads section of Outcome Measures page) The Centers for Medicare & Medicaid Services (CMS) explores hospital performance in the Medicare Hospital Quality Chartbooks. The Chartbooks review national performance trends, distribution, and regional variation, as well as other analyses relevant to questions and concerns raised by stakeholders.
- Chartbook 2012 for the mortality, readmission, and complication measure sets
- Chartbook 2011 for the AMI, HF, PN readmission measures
Resources for 2013 Public Reporting
- Frequently Asked Questions (FAQs), PDF-567 KB (Updated 10/07/13) includes general as well as measure-specific questions and responses for all publicly reported risk-standardized outcome measures.
- Readmission Measures Fact Sheet, PDF-331 KB (04/11/13) a general overview of the readmission measures, their development, and their purpose. A helpful introduction to the project for hospital staff and executives.
- Timeline, PDF-55 KB (04/11/13) a general timeline showing relevant dates from pre-implementation to the current reporting of the risk-standardized outcome measures.
- Readmission Calculator a tool that uses patient demographic and clinical characteristics to predict a patient's estimated risk of hospital readmission within 30 days of discharge for heart attack, heart failure, or pneumonia.
- HWR Cohort Assignment Flow Diagram, PDF-303 KB (04/11/13) an illustration and description of the process by which the HWR cohort is identified and an admission is assigned to one of the five mutually exclusive specialty cohorts.
AMI, HF, PN, HWR, and THA/TKA 2013 Condition Category - ICD-9-CM and Clinical Classification Software (CCS)-ICD-9 Crosswalks
The following documents show the relationship between ICD-9-CM codes and the condition categories (CCs) or the condition and procedure categories used to adjust for patient risk factors in each readmission measure.
- Acute Myocardial Infarction, CSV-207 KB (04/11/13)
- Heart Failure, CSV- 209 KB (04/11/13)
- Pneumonia, CSV-320 KB (04/11/13)
- HWR - Condition Category ICD-9-CM Crosswalk, CSV-239 KB (06/25/12)
- THA/TKA Readmission - Condition Category ICD-9-CM Crosswalk, CSV-291 KB (04/10/13)
The planned readmission algorithm in all the measures uses the Agency for Healthcare Research and Quality (AHRQ) Clinical Classifications Software (CCS) Procedure and Diagnosis codes for the assignment of potentially planned procedures and acute diagnoses. The HWR measure also uses the CCS codes in the specialty cohort assignments and to define some of the measure exclusions.
To access crosswalks between the AHRQ CCS diagnosis codes and ICD-9-CM codes and between the AHRQ CCS procedure codes and ICD-9-CM codes, visit the AHRQ website.
Resources for 2012 Dry Run HWR and THA/TKA
- 2012 Dry Run Summary Report – HWR and THA/TKA, PDF-393 KB (12/21/12) provides a detailed summary of the September 2012 dry run for the hospital-wide readmission (HWR) measure and the total hip and/or total knee arthroplasty (THA/TKA) readmission and complication measures. This report includes a summary of the dry run process, a summary of dry run results, and detailed summaries of email questions/comments received and CMS's response.
- Dry Run Timeline, PDF-68 KB (08/16/12) a general overview of key dry run dates.
- HWR Measure National Provider Conference Call September 11 and 24
- THA/TKA Measures National Provider Conference Call September 14
Questions and Comments
CMS has contracted with Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (YNHHSC/CORE) to support the implementation of these measures. Questions about the readmission measures should be sent to Yale at: email@example.com. To ensure proper handling of inquiries, please reference the specific measure(s) and the specific program(s) to which your questions relate. Do NOT submit patient-identifiable information (e.g., Date of Birth, Social Security Number, Health Insurance Claim Number) to this address.