Appropriate Care Measure (ACM)

Identified Participant Group
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In the 8th Statement of Work, The Centers for Medicare & Medicaid Services (CMS) is interested in measuring “the right care for every patient, every time.” To determine whether the patient received the right care [all that they were eligible to receive for either an acute myocardial infarction (AMI), heart failure (HF) or pneumonia (PN)], CMS developed a composite scoring methodology called the Appropriate Care Measure (ACM). It is comprised of the 10 required publicly reported measures. The ACM score is therefore a measure of how often the hospital “gets it right.” It is a new way to look at the quality of care provided in Prospective Payment System (PPS) hospitals.

 

EXAMPLE: If a patient with an acute myocardial infarction receives all the care he/she is eligible to receive while in the hospital, this counts as one episode of appropriate care. The hospital receives credit for this. If a patient receives only a part of the care he/she is eligible to receive, (i.e., does not receive aspirin recommendation at discharge) the patient has not received appropriate care and the hospital receives no credit for this episode of care.

 

The ACM score will be used as an overall measure of quality. Those hospitals participating in this

Identified Participant Group (IPG) will be expected to make significant improvements over the next three

years. There is no plan to publicly report these scores at the present time. CMS will continue to require

public reporting of the previously identified 10 measures (derived from the Medicare Modernization Act

of 2003) for fiscal years '06 and '07 in order for hospitals to be eligible for the full market basket update.

The 10 required measures will continue to be reported on www.HospitalCompare.hhs.gov

 

Benefits of Participating

Participating in the ACM IPG is an opportunity to:

• Enhance your hospital's reputation in the community by being able to show significant and
  verifiable improvement in quality care
• Work collaboratively with your medical staff on improving care
• Be recognized as an early adopter and leader of quality improvement standards
• Recruit and retain the best professionals possible
• Learn and adopt new quality improvement methodologies
• Enhance patient safety strategies
• Receive ACM data reports quarterly

Additional benefits:

• Access to resources and successful interventions
• Technical and data collection support
• Access to national benchmarking data
• Tools to help you communicate with your community

What Participation Involves

Hospitals will be asked to:

• Form a multidisciplinary team (i.e. physicians, nurses, Respiratory Care Practitioners, Quality
  Improvement experts, Pharmacists, Financial, IT, etc.)
• Conduct team meetings on a regular basis
• Develop an overall action plan and timeline
• Share progress, barriers and successes
• Strategize to incorporate a variety of improvement methods
• Meet with Ohio KePRO Project Leader once a month (Ideally this would be during a regularly
  scheduled team meeting)
• Demonstrate commitment through signature of the CEO
• Help identify physician or other clinical champions
• Continue to abstract same 10 core measures and submit to the clinical data warehouse

What Ohio KePRO will do for ACM IPG Hospitals

• Share best practices
• Facilitate utilization of the MedQIC web site ( www.MedQIC.org )
• Facilitate improvement on statewide goals (see below)
• Provide:
  - Monthly on-site visits
  - Quarterly ACM scores for each topic and overall
  - Topic-specific data
  - Resources to team as identified
  - Statewide teleconferences

What Ohio KePRO will do for Non-ACM IPG Hospitals

• Facilitate utilization of the MedQIC web site ( www.MedQIC.org )
• Facilitate improvement on statewide goals (see below)
• Provide:
  - Quarterly ACM scores for each topic and overall
  - Topic-specific data
  - Resources to team as identified
  - Statewide teleconferences

Statewide Hospital Quality Improvement Goals

Ohio KePRO will work with all Ohio hospitals toward improvement in the following areas:

• Increase the number of hospitals reporting the expanded set of twenty-two (22) quality measures
  for the Hospital Quality Alliance
• Increase the number of hospitals achieving a passing score (80% accuracy) on data validation
• Improve performance measure results on SCIP-1, prophylactic antibiotic received within one hour
  of surgical incision.
• Increase the number of critical access reporting hospitals by fifty percent (50%)

Evidence Based Literature

AMI

HF

PNE