This report examines the third year participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare public reporting database for hospital quality measures. The report updates previous national reports on Hospital Compare results for CAHs. There is also a policy brief profiling these same Year 3 findings.

The Flex Monitoring Team also produces state-specific reports with more detailed results. 

Results:

For 2006 discharges, 63% of CAHs participated in Hospital Compare by submitting data for at least one patient on one measure. (This total does not include 289 CAHs that submitted quality measure data for 2006 discharges to Q-Net Exchange, the national Quality Improvement Organization data warehouse, but did not allow the data to be publicly reported to Hospital Compare). CAH participation rates vary by state and by CAH organizational characteristics. By state, the percent of participating CAHs ranged
from 7.7% to 100%. Seven states had 100% of their CAHs participating. CAHs were more likely to report data on pneumonia and heart failure measures than on AMI and surgical infection prevention measures.

Similar to the first and second year results, for 2006 discharges, CAHs did not do as well on the AMI and heart failure measures as rural and urban PPS hospitals. For pneumonia and surgical infection prevention, CAHs scored as well or better than other hospitals on some measures, and not as well on other measures.

Among CAHs that reported Hospital Compare data for 2004, 2005 and 2006, the percent of CAH patients receiving recommended care increased for nearly all measures. The percent of rural and urban PPS hospital patients receiving recommended care also increased. Thus, CAHs continued to have lower scores relative to rural and urban PPS hospitals on several measures.

At the individual hospital level, substantial variation in quality results within the group of CAHs reporting at least 25 patients for a measure is further evidence of the potential for lower performing CAHs to improve the quality of care they provide.