CMS to focus on stroke care quality measures
A new rule from the Centers for Medicare & Medicaid Services (CMS Final FY 2010 Rule) focused on improving stroke patient care in hospitals. Beginning in 2010, hospitals submitting Medicare claims for stroke must let CMS know if they participate in a database registry for stroke care.

The rule also identified stroke care quality measures hospitals could be required to report for reimbursement beginning in 2012. The same measures have been part of the American Heart Association/American Stroke Association’s Get with the Guideline-Stroke (GWTG-Stroke) since 2001, according to the AHA.

“CMS has a series of measurements that it requires hospitals to provide in order to receive increased reimbursement under a program called Reporting of Hospital Quality Data for Annual Payment Update,” said Lee H. Schwamm, MD, chair of the GWTG National Steering Committee and director of the telestroke and acute stroke services at Massachusetts General Hospital in Boston. “Prior to this August, there were no measures that were specific for stroke, which is the third largest killer in the United States and one of the major causes of hospitalization.

The National Quality Forum, which reviews and endorses measures for use by quality organizations, insurance companies and CMS, has since endorsed eight of the measures and CMS is considering them for future reporting:
  • Deep vein thrombosis prophylaxis by end of hospital day two;
  • Discharged on antithrombotic therapy;
  • Patients with atrial fibrillation/flutter receiving anticoagulant therapy;
  • Thrombolytic therapy administered;
  • Antithrombotic therapy by end of hospital day two;
  • Discharged on statin medication;
  • Stroke education provided; and
  • Assessed for rehabilitation.

CMS also is considering including a measure of hospital stroke mortality derived from claims data.