Hospital 30-day, all-cause, risk-standardized mortality rate following heart failure hospitalization for patients 18 and older
The measure estimates a hospital 30-day risk-standardized mortality rate. Mortality is defined as death for any cause within 30 days after the date of admission of the index admission, for patients 18 and older discharged from the hospital with a principal diagnosis of HF. CMS annually reports the measure for patients who are 65 years or older and are either enrolled in fee-for-service Medicare and hospitalized in non-federal hospitals or are hospitalized in VA facilities.
ACP does not support this measure because it is not appropriately risk-adjusted. Recent literature identifies a set of patient characteristics for risk-adjustment that are significantly more robust than the characteristics currently used by CMS. Furthermore, this measure could have immediate financial impact on hospitals, and without accurate risk-adjustment, patient populations that need more care are going to be penalized. Targeting mortality rates would require significant resources to make minimal impact, but the hospitals that need the most impact have the most limited resources.