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.

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