Issue link: https://beckershealthcare.uberflip.com/i/1293502
31 QUALITY IMPROVEMENT & MEASUREMENT CMS shares proposed star ratings changes: 4 takeaways By Mackenzie Bean C MS has outlined proposed changes to the Overall Hospital Quality Star Rating methodology, which would take place next year. e agency shared the changes in its Outpa- tient Prospective Payment System proposed rule released Aug. 4. Four takeaways: 1. CMS sorts star rating quality measures into seven groups and uses a statistical mod- eling method called latent variable modeling to create a composite score for each group. e proposed methodology would scrap latent variable modeling and instead use a simple average of measure scores to calculate the group score. 2. CMS proposed combining three process measure groups — effectiveness of care, time- liness of care and efficient use of medical im- aging — into a single measure group labeled "timely and effective care." is consolidation would result in five measure groups instead of seven. e proposal aligns with the CMS Meaningful Measure Initiative, which aims to reduce the regulatory hurdles associated with quality reporting. Star ratings currently include 51 quality measures, down from 64 when they launched in 2016. 3. To receive a star rating, hospitals must share data on at least three measures in at least three measure groups, one of which must be the mortality or safety of care outcome group. CMS said the proposed consolidation of measure groups would help 157 more critical access hospitals meet this threshold to receive a ranking. At present, these facilities serve too few patients to report measures for each group. 4. Hospital groups and industry leaders have long called for changes to the star ratings system, saying the methodology is flawed and produces misleading results. Hospital groups responded fairly positively to the latest proposed changes. "In light of the substantial flaws with CMS's current approach to hospital star ratings, we appreciate that the agency is exploring ways of improving the methodology," Tom Nick- els, executive vice president of the American Hospital Association, said in a statement. "We look forward to reviewing the proposed methodology changes in depth." n Study links higher ICU bed occupancy to more COVID-19 deaths By Mackenzie Bean T he number of hospital beds occupied by COVID-19 patients in a state is strongly linked to mortality, a study published in the Journal of General Internal Medicine found. Researchers analyzed data from 23 states that reported daily hos- pitalization data to the University of Minnesota COVID-19 Hospi- talization Tracking Project between March 20 and June 4. COVID-19 patients occupied 19.6 percent of all intensive care unit beds and 5.5 percent of non-ICU beds relative to state capacity during the study period. Researchers found a 1 percentage point increase in ICU bed use (17 ICU beds, on average) was linked to 2.84 more COVID-19 deaths in the following seven days. A 1 percentage point increase in non-ICU bed use (130 beds, on average) was linked to 17.84 more deaths. These results remained constant across numerous models with al- ternate specifications. ICU bed use also had a stronger association to mortality than non-ICU bed use. "These estimates provide a better understanding of the projec- tions of the COVID-19 pandemic in the U.S., especially when states are monitoring economic activities, and provide important practice insights for hospitals in terms of assessment of hospital bed and ICU bed capacity and preparedness," lead author Pinar Karaca-Mandic, PhD, professor and academic director of the Medical Industry Leadership Institute at U of M's Carlson School of Management in Minneapolis, said in a news release. n No link between blood type and COVID-19 severity, Harvard researchers say By Mackenzie Bean A patient's blood type does not influence whether he or she will have a more severe case of COVID-19, a study pub- lished in Annals of Hematology found. Researchers at Boston-based Harvard Medical School examined data on 1,289 symptomatic adults who tested positive for the COVID-19 at five Boston hospitals between March 6 and April 16. They found no meaningful correlation between blood type and clinical outcomes of severity, such as hospitalization, intubation or death. There was also no connection between blood type and inflammatory markers, which is significant as COVID-19 is widely thought to cause systemic inflammation in the body, researchers noted. While blood type did not play a role in COVID-19 severity, it may influence an individ- uals' chance of getting the virus. Researchers found patients with blood types B positive and AB positive were more likely to test positive for COVID-19. Patients with type O blood were less likely to have a positive result, which coincides with previous research on the topic. n