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Rural Relevant Quality Measures for Critical Access Hospitals

Authors

  • Michelle M. Casey MS,

    1.  Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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  • Ira Moscovice PhD,

    1.  Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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  • Jill Klingner RN, PhD,

    1.  Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
    2.  Labovitz School of Business and Economics, University of Minnesota-Duluth, Duluth, Minnesota
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  • Shailendra Prasad MBBS, MPH

    1.  Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
    2.  Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
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  • Funding: Support for this paper was provided by Grant U27RH01080–08-00 from the federal Office of Rural Health Policy, Health Resources and Services Administration.Disclosures: The funding agency for this study, the federal Office of Rural Health Policy, reviewed and commented on an earlier version of this paper.Acknowledgments: We thank our expert panel for sharing their knowledge about hospital quality measurement and rural hospitals. The panel members were: Dale Bratzler, DO, MPH, University of Oklahoma Health Sciences Center; Thomas Dean, MD, Horizon Health Care, Wessington Springs, SD; Nancy Foster, Vice President for Quality and Patient Safety Policy, American Hospital Association, Washington DC; Jennifer Lundblad, CEO, Stratis Health, Bloomington, MN; Cathleen Pfaff, RN, Cypress Healthcare, Deer Lodge, MT; and Brock Slabach, Senior Vice President, National Rural Health Association. We also thank the Office of Rural Health Policy staff; Jeff Stensland, MedPAC staff; Andy Coburn, University of Southern Maine; the Joint Commission Critical Access Hospital Technical Advisory Panel and staff; and the JRH reviewers for their helpful comments. For further information, contact:Michelle M. Casey, University of Minnesota Rural Health Research Center, 2520 University Avenue SE, #201 Minneapolis, MN 55414; e-mail: mcasey@umn.edu.

Abstract

Purpose: To identify current and future relevant quality measures for Critical Access Hospitals (CAHs).

Methods: Three criteria (patient volume, internal usefulness for quality improvement, and external usefulness for public reporting and payment reform) were used to analyze quality measures for their relevance for CAHs. A 6-member panel with expertise in rural hospital quality measurement and improvement provided input regarding the final measure selection.

Findings: The relevant quality measures for CAHs include measures that are ready for reporting now and measures that need specifications to be finalized and/or a data reporting mechanism to be established. They include inpatient measures for specific medical conditions, global measures that address appropriate care across multiple medical conditions, and Emergency Department measures.

Conclusions: All CAHs should publicly report on relevant quality measures. Acceptance of a single consolidated set of quality measures with common specifications for CAHs by all entities involved in regulation, accreditation, and payment; a phased process to implement the relevant measures; and the provision of technical assistance would help CAHs meet the challenge of reporting.

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