CMS Uses AHRQ's Quality Indicators to Evaluate Care for Medicare Beneficiaries

The Medicare Payment Advisory Commission (MedPAC) used AHRQ's Quality Indicators to evaluate the quality of care for Medicare's 40 million beneficiaries. The results of the Commission's application of the indicators populated its March 2004 report to Congress addressing a variety of payment policy issues.

MedPAC applied mortality measures from AHRQ's Inpatient Quality Indicators to the Medicare Provider Analysis and Review data sets from 1995, 1998, 2000, and 2002. Then, they quantified inpatient mortality and 30-day mortality for such conditions as pneumonia, acute myocardial infarction, stroke, and congestive heart failure.

To evaluate patient safety in the hospital, MedPAC used AHRQ's Patient Safety Indicators to identify adverse events, such as pressure ulcers, postoperative complications, and iatrogenic injuries. Lastly, applying the Prevention Quality Indicators, they studied the trends in the rates of potentially preventable hospital admissions.

Using this report, the Chairman of MedPAC, Glenn Hackbarth, testified before the Subcommittee on Health of the House Committee on Ways and Means on March 18, 2004. His testimony, titled "Improving Quality through Medicare Payment Policy," identified AHRQ as the source of the tools needed to document and follow critical markers of the quality of care delivered to Medicare beneficiaries. Carolyn Clancy, MD, also testified at this meeting, offering a unique opportunity for Congressional members to hear about AHRQ's research agenda, complemented by MedPAC's demonstration of how AHRQ's research is utilized by stakeholders to provide useful and quantitative data that can be used by decision-makers to affect health care policy.

MedPAC is an independent federal body established by the Balanced Budget Act of 1997 (P.L. 105-33) to advise Congress on issues affecting the Medicare program. MedPAC's statutory mandate is quite broad. In addition to advising Congress on payments to private health plans participating in Medicare and providers in Medicare's traditional fee-for-service program, MedPAC also analyzes access to care, quality of care, and other issues affecting Medicare. More information is available at www.medpac.gov.