The Pennsylvania Medicare Rural Hospital Flexibility (Flex) Program received an inaugural State Quality Ranking Award for quality and reporting for the state’s 13 Critical Access Hospitals (CAHs). The award was presented during a meeting held in Bethesda, Maryland, June 23-24. The award was presented by the Federal Office of Rural Health Policy of the Health Resources and Services Administration, U.S. Department of Health and Human Services.
Pennsylvania was acknowledged, together with 11 other states, for reporting on inpatient and outpatient services and for completing and submitting patient satisfaction scores through the use of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a national standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care. Pennsylvania was one of the first states to achieve 100 percent reporting from all CAHs on these metrics.
The quality reporting is a component of the Medicare Beneficiary Quality Improvement Project (MBQIP), a quality improvement activity under the federal Flex grant program. The goal of MBQIP is to improve the quality of care provided in small, rural CAHs by increasing the voluntary quality data reporting by CAHs and then driving quality improvement activities based on the data. The project provides an opportunity for individual hospitals to look at their data, measure their outcomes against other CAHs, and partner with other hospitals in the state on quality improvement initiatives to improve outcomes and provide the highest quality care to all patients.
A CAH is a small rural hospital certified under a set of Medicare Conditions of Participation (CoP). Some of the requirements for CAH certification include having no more than 25 inpatient beds; maintaining an annual average length of stay of no more than 96 hours for acute inpatient care; offering 24-hour, seven-day-a-week emergency care; and being located in a rural area, at least 35 miles drive away from any other hospital or CAH.
The limited size and short stay length allow CAHs to focus on providing care for common conditions and outpatient care, while referring other conditions to larger hospitals. The CAH program in Pennsylvania is administered through the Pennsylvania Office of Rural Health (PORH), located at the Penn State University Park campus.
Larry Baronner, PORH’s rural health systems manager and deputy director, who coordinates the CAH program in Pennsylvania, noted “The Pennsylvania Critical Access Hospital Quality Improvement (QI) Directors have made a concerted effort to measure quality performance in their hospitals. They are continually striving to improve quality performance while tasked with performance reporting to nine or more federal and state agencies. The QI Directors are to be commended for their efforts to prove that high-quality health care can be obtained in Pennsylvania's Critical Access Hospitals.”
In addition to MBQIP, Pennsylvania’s CAHs report performance measurement and improvement data to a number of other organizations including the Pennsylvania Department of Health, the Pennsylvania Patient Safety Reporting System, and the Pennsylvania Health Care Cost Containment Council. This reporting reinforces that the quality of health care services provided at CAHS meets or exceeds the quality of care found in non-CAH facilities.
PORH was established in 1991 to enhance the health status of rural Pennsylvanians and strengthen the delivery and quality of care in the communities in which they live. To learn more about the Pennsylvania Office of Rural Health, visit www.porh.psu.edu.