Assignment Content

Consumers increasingly have access to a wide range of performance metrics regarding healthcare organizations and providers. One example is the ability to compare hospital quality using data provided by The Joint Commission and by the Centers for Medicare and Medicaid Services. In this exercise, you will get to reflect on performance data from the patient point of view.

The attached document includes tables from two data sources. Table $1$ uses CMS data to show national expenditures $($average Medicare payments$)$ and patient volume $($number of discharges$)$ per select MS$-$DRGs in FY $2019.$

DRGs $291,292,$ and $293$;

DRGs $469,470$;

DRGs $193,194,$ and $195.$

Table $2$ uses data from Hospital Compare to compare the quality of care at Baptist Memorial Hospital and Methodist Healthcare Memphis Hospitals in Memphis, TN$.$ The focus is on Heart Failure, Hip$/$Knee Replacement, and Pneumonia indicators $($the conditions represented by the DRGs in Table $1),$ as well as patient satisfaction with hospital care $($derived from the HCAHPS survey$).$

Note that some measures in the table are compared statistically to national averages. A hospital's performance can be greater than, less than, or no different than national averages from a statistical standpoint. For example, while hospital X$\text{'}$s readmission rate of $5\%$ is obviously greater than a national average of $4\%,$ the two rates may or may not be statistically different $($i$.$e$.,$ the difference may not matter for evaluation and comparison purposes$).$

HLTH$6100\_$W$1\_$A$1\mathrm{.}3\_$Table$\_2019.$pdf

Use the information in the tables provided and identify outside research to answer the questions below:

Why does CMS focus on Heart Failure, Hip$/$Knee Replacement and Pneumonia for its quality improvement activities? Provide external support for your argument.

How do the Baptist and Methodist hospitals compare to the national and state benchmarks $($averages$)$ in heart failure, hip$/$knee replacement, and pneumonia measures?

Articulate at least one reason why any difference that exists may be important.

What are the implications of such differences for each of the following stakeholders: patients, providers, and hospital administrators?

How do the Baptist and Methodist hospitals compare to each other?

What are the implications of such differences for each of the following stakeholders: patients, providers, and hospital administrators?

What are the three lowest scored HCAHPS categories?

What do they suggest about how hospitals could improve the patient experience? Is such improvement important? Why?