The Centers for Medicare and Medicaid Services is proposing to collect from hospitals two measures of healthcare-acquired infections, beginning with Jan. 1, 2011 discharges, which would influence Medicare payment determinations starting in fiscal year 2013.

The measures would cover central line associated blood stream infections and surgical site infections, according to a proposed rule for inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system for fiscal year 2011. CMS published the proposed rule on May 4 in the Federal Register. The agency, in the rule, expressed concern about the lack of progress in reducing the rates of health care-associated infections that was recently reported in the 2009 National Healthcare Quality Report.

In the proposed rule, CMS reiterates its intention to collect data for the Reporting Hospital Quality Data for Annual Payment Update program, known as RHQDAPU, from registries to enable expansion of the program without increasing data collection burdens on hospitals. "We continue to evaluate the feasibility of leveraging registry-based data collection mechanisms for the RHQDAPU program and we are proposing to collect such data for the FY 2013 payment determination."

CMS further continues to be interested in the reporting of quality measures through electronic health records. "The electronic specifications and interoperability standards for EHR-based collection and transmission of the data elements for the ED Throughput, Stroke and Venous Thromboembolism measures have been finalized by the Health Information Technology Standards Panel and are available for review and testing at," according to the proposed rule. "We anticipate testing the components required for the submission of clinical quality data extracted from EHRs for these measures, and are exploring different mechanisms and formats that will aid the submission process, as well as ensure that the summary measure results extracted from the EHRs are reliable. We anticipate moving forward with testing CMS' technical ability to accept data from EHRs for the ED, Stroke and VTE measures as early as summer of 2011."

The proposed rule is available at

--Joseph Goedert


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