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Quality Background

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Avera Quality Fact Sheet

  • Approximately 270 hospitals across the United States are in the demonstration. The only participating hospitals in South Dakota are Avera McKennan, Avera Queen of Peace, Avera Sacred Heart, Avera St. Luke’s and Rapid City Regional.
  • Avera is voluntarily participating in this three-year CMS demonstration designed to improve the quality of inpatient care called the Hospital Quality Initiative Demonstration.(HQID)
  • The Centers for Medicare & Medicaid Services (CMS) and Premier, Inc., an alliance of 1,500 not-for-profit hospitals, conduct HQID.
  • Avera is part of this demonstration to test our belief that higher-quality care produces better results for patients and reduces overall health care costs.
  • According to CMS, “This is a demonstration to test if providing financial incentives to hospitals that demonstrate high-quality performance in a number of areas of acute inpatient care will improve patient outcomes and reduce overall costs for Medicare.”
  • Premier believes, “This demonstration is a critical milestone for health care. The lessons learned from it should play an important role in the development of future models.”
  • Avera and our physicians always focus on providing the highest-quality patient care. We are interested in learning new ways to improve care and treatment results for our patients. At the same time, we want to reduce the cost of care. We welcome this challenge to strive for even higher levels of quality care based on national performance standards.
  • Through this project, Avera and other participating hospitals voluntarily report their quality data for five high-volume inpatient conditions according to national measures of quality care.
  • The five clinical conditions being studied and tracked include acute myocardial infarction, coronary artery bypass graft, heart failure, pneumonia and hip and knee replacement surgery.
  • Some 34 nationally defined, standardized measures are tracked. The demonstration evaluates whether the care provided consistently meets accepted evidence-based practice standards. These proven care standards lead to better patient outcomes and reduce the risks of complications and death. Participating hospitals receive regular comparative reports on quality and cost of care and compete for top performer recognition.
  • Each year of the three-year demonstration, CMS will pay top performers more for delivering high-quality health care and will publish the quality results of the top 50 percent of participants.
  • Hospitals that perform in the top 10 percent will receive a 2 percent bonus on their Medicare DRG payments for the given clinical condition(s); those performing in the next 10 percent will receive a 1 percent bonus on their base Medicare DRG payments for the given clinical condition(s).