Medicare to Keep Hospital Mistake Data On Website

The story about Medicare removing information about hospital-acquired conditions from its website appears to be changing.

I wrote on Monday about a rule change being proposed by the Centers for Medicare and Medicaid Services that would result in the deletion of information on its Hospital Compare site about eight different “hospital-acquired conditions,” including objects accidentally left in the body after surgery and blood infections from catheters.

Within hours of my post going up, Cheryl Clark at HealthLeaders Media  pointed me to her own post on the topic. On May 16 she wrote:

The problem is, the Bloomberg story was erroneous, CMS officials told me. I don't want to pick on Bloomberg; Lord knows they've got enough problems on their hands this week. And I understand why the error occurred–there's enough blame to go around to numerous entities.

Her source was Dr. Patrick Conway, Medicare’s chief medical officer. She wrote:

What is changing, he explains, is that some of these measures will no longer be part of the Inpatient Quality Reporting program, for which hospitals have received a 2% market basket pay increase in exchange for reporting the data. CMS will still get the data, but the hospitals won't get paid for submitting it. … Just because a measure is not reported to the IQR program, it doesn't mean that it will be taken off Hospital Compare," he says. These eight measures, of the 11 hospital-acquired conditions for which Medicare denies hospitals reimbursement under provisions of the 2005 Deficit Reduction Act (DRA), and which are now posted on Hospital Compare, "will continue to be displayed and available in the downloadable database after July, 2013."

So why didn’t Conway tell Bloomberg’s Charles R. Babcock the same thing when he called for his story? Babcock wrote in his story:

Patrick Conway, CMS’s chief medical officer and top quality-control official, declined to be interviewed and didn’t respond to written questions about the HACs’ removal, the new measures and when they might appear on the site.

I contacted Conway myself and asked him the following questions:

Why did you decide not to respond to questions from Bloomberg reporter Charles Babcock about this proposed change? (Here's his story: http://www.bloomberg.com/news/2013-05-02/u-s-to-delete-data-on-life-threatening-mistakes-from-website.html)

Having read the proposed rule change, I can very much see why Babcock thought that CMS was going to change the way it reported HACs. What do you think prompted the story? 

When did CMS decide that it needed to start making public statements saying that the Bloomberg story was wrong about the proposed change? 

Has CMS asked Bloomberg to correct the story?

Conway wrote me back promptly and told me to work through the press office there. So I did.

After an exchange with the press office and no on-the-record answers to my questions, I was given the following comment from Kathryn Ceja in the CMS Office of Communications.

These patient safety measures are extremely important, and CMS is working to streamline its programs so that hospitals can successfully reduce the incidence of HACs. The eight DRA HACs will continue to be displayed and available in the downloadable database after July 2013.  Following the MAP’s recommendations, CMS did remove a number of claims-based safety measures from the Inpatient Quality Reporting program.  Despite their removal from IQR, CMS will continue to calculate these claims-based measures and supply data via data.cms.gov.  Moreover, third parties also have the option of requesting claims data through ResDAC, and calculating the claims based HAC measures themselves.

But I was still left wondering whether Medicare started the wheels in motion to remove this data from Hospital Compare and had a change of heart after the Bloomberg story. Remember that Bloomberg had to have gotten this idea somewhere. There are numerous groups in his story criticizing the proposed rule change, including the LeapFrog Group and the Pacific Business Group on Health. How did those groups get the wrong idea?

And then there’s the committee that recommended the proposed rule change in the first place. Babcock writes:

In addition, the Measure Applications Partnership or MAP, the group created by the health-care overhaul law, recommended that CMS instead use hospital-acquired conditions endorsed by the National Quality Forum. MAP is part of the nonprofit, which advises the U.S. government and hospitals on best practices. … “It’s better to have measures that might not meet the highest level of statistical reliability than to ask your next- door neighbor,” said Dolores Mitchell, executive director of the health-care program for Massachusetts state employees, who said she was the only member of the MAP panel that opposed removing the HACs.

Were all of these people wrong about the data being removed from the website?

Well, surely if CMS had thought Bloomberg’s story was wrong, it would have asked Bloomberg to correct the story, right?

I contacted the reporter, Charles R. Babcock, but I didn’t receive a reply. (This is not surprising given both the volume of email reporters receive and the general feeling most reporters have that they should be the ones asking questions.)

Then I contacted other reporters who have written about this to see if they have been asked to correct their own stories, including FierceHealthIT and iHealthBeat.

I’ll let you know if I hear anything.