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Q U A L I T Y S T A N D A R D S quite a bit lower than they should be." Yes, he says, the value-based purchasing program will drive improvement because it identifies measurements that are going to be made public (no hospital wants to take a PR hit) and affect payments. "But after most hospitals improve on certain measures, the variability goes away," says Mr. Shoemaker, who points out the program will define different sets of measures for each fiscal year moving forward. Essentially, he says, value-based purchasing targets narrow sets of measures where there's variability, not necessarily the most important quality measures. Public reporting of how hospitals' performances fare against national averages, which appear on Medicare's Hospital Compare website (medicare.gov/ hospitalcompare), is part of the value-based purchasing program. But you can't know which hospitals provide high-quality care based solely on the website's data because measures on which hospitals are uniformly performing well are systematically excluded, says Nancy Foster, vice president of quality and patient safety for the 6 SUPPLEMENT TO QUALITY REPORTING G-Codes to Know If no adverse events occur, report: G8907 All 4 adverse events did not occur If 1 or more adverse events occur, report 4 of the following: G8908 Patient burn G8909 Patient burn did not occur G8910 Patient fall G8911 Patient fall did not occur G8912 Wrong-event surgery G8913 Wrong-event surgery did not occur PERFORMANCE INDICATORS Key Hospital Quality Measures Surgical care improvement Patient experience of care measures (measured in success rates): (measured in success rates): • Staff orders recommended • nurses communicated well (always) • physicians communicated well (always) venous thromboembolism prophylaxis. • help received quickly (always) • Patients receive appropriate venous thromboem- • pain controlled well (always) bolism prophylaxis within 24 hours of surgery. • staff explained medications (always) • Patients on beta blockers before arrival receive beta blockers during perioperative • facility kept clean (always) period. • given discharge instructions (yes) • overall hospital rating (high) G8914 Hospital transfer/admission • would recommend hospital (definitely) G8915 Hospital transfer/admission did not occur Always report 1 of the following: G8916 IV antibiotic started on time G8917 IV antibiotic not started on time G8918 Patient did not have pre-op order for IV antibiotic American Hospital Association. She says patient survey data included on the website help depict quality of care that's best assessed from the patient perspective. The AHA believes, however, that significant improvements should be made to the survey tool and, until that happens, the data shouldn't be weighted as heavily in calculating value-based purchasing scores. O U T PAT I E N T S U R G E R Y M A G A Z I N E | J A N U A R Y 2013 Focus on what matters program." OSM Dr. Shapiro says ASC quality data report- E-mail dcook @outpatientsurg ery.net. ing will evolve into pay-for-performance based on the value-based purchasing model. Will the 2 programs eventually merge? That's uncertain. What's clear is reimbursement tied to some form of quality measures is here to stay. Embrace the new payment model, but don't lose sight of what drives you and your staff to excel. "Take the best possible care of patients because it's the right thing to do," says Dr. Shapiro. "Not because it will make your statistics look good for some reporting J A N U A R Y 2013 | S U P P L E M E N T TO O U T PAT I E N T S U R G E R Y M A G A Z I N E 7