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The Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS), has announced important additions to the Hospital Compare consumer Web site (http://www.hospitalcompare.hhs.gov/) that will give consumers even better insight into the quality of care provided by their local hospitals.

The improvements include the addition of a mortality measure for pneumonia and, for the first time on Hospital Compare, publicly reported measures for hospital care of children. Previously, Hospital Compare had provided only quality information based on hospitalizations of adult patients.

Since its inception in March 2005 Hospital Compare has become a popular tool for consumers and their care givers in making health care decisions. The addition of patient experience data and Medicare payment and volume information in March 2008 caused the number of page views to jump from an average of 600,000 per month to more than 2.5 million per month. Page views for this year to date have totaled more than 20 million.

"Reporting quality data on the care provided hospital patients is a key to our continuing effort to provide better, value-based health care for all Americans," HHS Secretary Mike Leavitt said. "Expanding the scope of measures is making Hospital Compare a more valuable tool for all health care consumers."

Earlier this year, Medicare added patient satisfaction information to the Web site. Today's additions bring the total to 26 process of care measures, three outcome of care measures, two children's asthma care measures, and 10 patient experience of care measures. Hospital Compare also contains information about the number of certain elective hospital procedures provided to patients and what Medicare pays for those services.

"CMS' goal for updating and enhancing the Hospital Compare Web site is to provide usable and accurate information about hospital performance to providers and communities that will encourage hospitals to excel in the quality of care they provide," said CMS Acting Administrator Kerry Weems. "With these new enhancements, consumers and health care providers will be able to look at individual hospital mortality scores. We hope that this new information will cement the Web site's role as a key driver in improving the quality and reliability of care in the nation's hospitals."

"The 30-day Medicare mortality data will strengthen quality improvement partnerships in hospitals by encouraging better handoffs and communication," said Carolyn M. Clancy, M.D., AHRQ's director. The addition of pediatric quality measures also is an important step in ensuring that our nation's hospitals provide high quality health care."

The measure on pneumonia 30-day mortality joins existing 30-day mortality measures heart failure (HF) and heart attack (AMI), which CMS began reporting last summer. Since last summer, CMS has seen improvement nationally on mortality rates for heart attack. The rate of 30-day heart attack mortality dropped from 16.3 percent reported in 2007 to 16.1 percent reported in 2008.

Hospitals varied less in their rates: for example, there are no longer any hospitals whose heart attack mortality rates were low enough to classify them as "worse than the U.S. national rate" under CMS' mortality rate classification system. In other words, CMS' calculations predicted that while some hospitals' rates are lower than the U.S. national rate, they are not low enough to consider them "worse" than the U.S. national rate with a great degree of certainty (or "statistical significance").

The pneumonia mortality measure, like its predecessors, has been endorsed by the National Quality Forum (NQF) and is supported by the Hospital Quality Alliance (HQA). The mortality outcome measures are risk-adjusted and take into account previous health problems to "level the playing field" among hospitals. The measures are also intended to help ensure accuracy in performance reporting.

In addition to new information about pneumonia mortality, CMS is releasing new information to the Hospital Compare Web site that will allow consumers and hospitals to drill down beyond the categorical information of the mortality measures for each hospital -- whether the hospital's mortality rate is "Better than," "No different from," or "Worse than" the U.S. national rate.

This new data information includes each hospital's risk-standardized mortality rate, an estimate of the rate's certainty (also known as the interval estimate), and the number of eligible cases for each hospital. By posting hospital RSMRs, interval estimates, and number of eligible cases, CMS is giving consumers and communities additional insight into the performance of their local hospitals in hopes that this will prompt all hospitals to work toward achieving the level of the top-performing hospitals in the country.

This information will also serve as a benchmark where Medicare beneficiaries and other consumers can determine - on a year-by-year basis - whether their hospital is improving for these important outcome measures.

The children's asthma care measures added today are relievers for inpatient asthma, and systemic corticosteroids for inpatient asthma. By including these measures, CMS and HQA begin providing the public with information about the quality of children's care in hospitals, including in pediatric hospitals, for the first time.

Through the Hospital Compare Web site, CMS is working to implement the principles of a value-based system in the Medicare program. The enhancements to the site further empower consumer choice and create incentives by motivating providers to provide better care for less money. An Executive Order issued in 2006 by President Bush directed that federal agencies that sponsor or subsidize health care commit to the fourcornerstones of value-driven health care: ensuring transparent quality and price information, interoperablehealthinformation technology and incentives for high-quality, efficient health care delivery (http://www.hhs.gov/valuedriven).

The Hospital Quality Alliance is instrumental in facilitating CMS's communication with hospitals and helping to motivate those hospitals to continually analyze and improve the quality of their care. Collaboration by the members of the HQA continues to ensure that public reporting efforts for hospitals are supported by a broad cross section of the health care community.

Public reporting of these and other measures is intended to empower patients and their families with information with which to engage their local hospitals and physicians in active discussions about quality of care.

To help hospitals use the 30-day mortality data as a quality improvement tool, CMS provided detailed reports to each hospital listed on the Web site. CMS believes that all hospitals, regardless of their mortality rates, should use the data available in these free, detailed reports to find ways to continually improve the care they deliver.

CMS urges consumers not to view any one process or outcome measure on Hospital Compare as a tool to "shop" for a hospital. The information contained on Hospital Compare is one additional tool for consumers to use in making healthcare decisions, although consumers should gather information from multiple sources when choosing a hospital. For example, patients and caregivers could use the Web site to help them discuss plans of care with their trusted healthcare providers. In an emergency situation, patients should always go to the nearest, most easily accessible facility.

The Hospital Compare website can be accessed at http://www.hospitalcompare.hhs.gov/

Short cut URL to mortality information (Minitool): http://www.hospitalcompare.hhs.gov/hospital/mortalitytool/index.asp