Provider Data on Comprehensive Care for Joint Replacement Model

$179 / year

This dataset includes provider data for two quality measures tracked during an episode of care that contains complication rate for hip and knee replacement patients and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey information.

Complexity

The Provider Data on Comprehensive Care for Joint Replacement Model is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide to Medicare beneficiaries.

The Comprehensive Care for Joint Replacement (CJR) model encourages physicians, hospitals, and post-acute care providers to work together to improve quality of care for patients undergoing hip and knee replacement inpatient surgeries. This model tests bundled payment and quality measurement for an episode of care associated with hip and knee replacements to encourage hospitals, physicians and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery.

The CJR model tracks two quality measures during an episode of care:
– Complication rate for hip/knee replacement patients for Hospital-level risk-standardized complication rate (RSCR) following Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA).
– Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey, calculated as an HCAHPS Linear Mean Roll-Up Score.
The CJR model also encourages hospitals to voluntarily submit data on Patient-Reported Outcomes (PROs) for patients undergoing hip/knee replacements (THA/TKA PROs) and limited data on risk variables race and ethnicity, Body Mass Index (BMI) or weight and height, and patient health literacy.

Hip and knee replacements are the most common inpatient surgery for Medicare beneficiaries and can require lengthy recovery and rehabilitation periods. In 2014, there were more than 400,000 procedures, costing more than $7 billion for the hospitalizations alone. Despite the high volume of these surgeries, quality and costs of care for these hip and knee replacement surgeries still vary greatly among providers. For instance, the rate of complications like infections or implant failures after surgery can be more than three times higher at some facilities than others, increasing the chances that the patient may be readmitted to the hospital. And, the average Medicare expenditure for surgery, hospitalization and recovery ranges from $16,500 to $33,000 across geographic areas. CMS has implemented the CJR model in 67 geographic areas, defined by metropolitan statistical areas (MSAs). MSAs are counties associated with a core urban area that has a population of at least 50,000. Non-MSA counties (no urban core area or urban core area of less than 50,000 population) were not eligible for selection.

The CJR model holds participant hospitals financially accountable for the quality and cost of a CJR episode of care and incentivizes increased coordination of care among hospitals, physicians and post-acute care providers. In the CJR model, beneficiaries retain their freedom of choice to choose services and providers. Physicians and hospitals are expected to continue to meet current standards required by the Medicare program. All existing safeguards to protect beneficiaries and patients remain in place.

In this dataset, the start and end measure dates for Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) covers the period from 1st July 2016 to 30th June 2017 and complications measure cover the period from 1st April 2014 to 31st March 2017. The start and end measure dates for patient-reported outcomes covers the period from 1st September 2016 to 30th June 2017.

Date Created

2017-06-01

Last Modified

2020-04-21

Version

2020-04-21

Update Frequency

Quarterly

Temporal Coverage

2017-2018

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare & Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Hip and Knee Replacement Patients, Comprehensive Care For Joint Replacement, Total Hip and Knee Arthroplasty, Patient's Episode of Care, Complications Rate For Hip and Knee Replacement, Patient-Reported Outcomes, Medicare Beneficiaries, Provider Data on Comprehensive Care, Metropolitan Statistical Area

Other Titles

Comprehensive Care for Joint Replacement Model for Provider Data, Complication Rate for Hip and Knee Replacement for Episode of Care, CJR Model Data on Patients Reported Outcomes About Hip and Knee Replacement

NameDescriptionTypeConstraints
Provider_IDCMS certification number (CCN). Identification number of the hospital within the CMS dataset. The CCN for providers and suppliers is a 6 digit number. The first 2 digits identify the State in which the provider is located. The last 4 digits identify the type of facility.integerlevel : Nominal
Hospital_NameName of the hospital (also referred to as the provider).string-
Metropolitan_Statistical_Area_CodeIndicates the code for metropolitan statistical area comprehensive care for joint replacement model.integerlevel : Nominal
Metropolitan_Statistical_Area_NameIndicates the name for metropolitan statistical area comprehensive care for joint replacement model.string-
State_AbbreviationCommonwealth of the Northern Marianas Islands: MPstring-
HCAHPS_HLMRIndicates the HCAHPS Linear Mean Roll-up (HLMR) score. The HLMR score summarizes performance across the publicly-reported HCAHPS measures, with the exception of Pain Management. The HLMR is the average of the linear mean scores (LMS) of the HCAHPS measures, using a weight of 1.0 for each of the 6 HCAHPS composite measures (excluding Pain Management), and a weight of 0.5 for each of the single item measures (Cleanliness, Quietness, Overall Hospital Rating, and Recommend the Hospital).numberlevel : Ratio
HCAHPS_FootnoteFootnote describes an additional piece of information given separately for the compiled HCAHPS data.string-
HCAHPS_HLMR_PercentileIndicates the HCAHPS Linear Mean Roll-up (HLMR) Percentile.numberlevel : Ratio
Hip_Knee_Complications_RateIndicates the complication rate for Total Hip and Knee Arthroplasty.numberlevel : Ratio
Complications_Footnote_CodeFootnote code of an additional piece of information given separately for the compiled complications data.integerlevel : Nominal
Complications_Footnote_DescriptionFootnote description of an additional piece of information given separately for the compiled complications data.string-
Hip_Knee_Complications_PercentileIndicates the percentage for Total Hip and Knee Arthroplasty.numberlevel : Ratio
Is_Patient_Reported_OutcomesWhether the patient-reported outcomes is assessed or not.boolean-
Reconciliation_FootnoteFootnote describes an additional piece of information given separately for the compiled reconciliation data.string-
Provider IDHospital NameMetropolitan Statistical Area CodeMetropolitan Statistical Area NameState AbbreviationHCAHPS HLMRHCAHPS FootnoteHCAHPS HLMR PercentileHip Knee Complications RateComplications Footnote CodeComplications Footnote DescriptionHip Knee Complications PercentileIs Patient Reported OutcomesReconciliation Footnote
10001SOUTHEAST ALABAMA MEDICAL CENTER20020DothanAL81.750.13.190.2FalseIneligible for reconciliation based on performance on CJR-specific quality measures
10023BAPTIST MEDICAL CENTER SOUTH33860MontgomeryAL84.130.32.640.5False
10055FLOWERS HOSPITAL20020DothanAL86.50.63.250.1False
10092D C H REGIONAL MEDICAL CENTER46220TuscaloosaAL83.560.23.20.2FalseIneligible for reconciliation based on performance on CJR-specific quality measures
40026CHI ST. VINCENT HOSPITAL HOT SPRINGS26300Hot SpringsAR84.440.32.570.5False
40078NATIONAL PARK MEDICAL CENTER26300Hot SpringsAR81.810.12.550.5False
50018PACIFIC ALLIANCE MEDICAL CENTER31080Los Angeles-Long Beach-AnaheimCAToo few completed surveys or months of data to calculate HCAHPS Linear Mean Roll-up score1.0The number of cases/patients is too few to report.False
50056ANTELOPE VALLEY HOSPITAL31080Los Angeles-Long Beach-AnaheimCA80.190.12.27Hip_Knee_Complications_Percentile+K6:P60.8False
50063HOLLYWOOD PRESBYTERIAN MEDICAL CENTER31080Los Angeles-Long Beach-AnaheimCA78.810.12.540.5False
50069ST JOSEPH HOSPITAL31080Los Angeles-Long Beach-AnaheimCA87.880.82.70.4False