The inverse relationship between mortality rates and performance in the Hospital Quality Alliance measures.

The Hospital Quality Alliance (HQA) program gives us the opportunity to systematically monitor the quality of hospital care nationwide. To gauge the importance of the HQA indicators, we examined the relationship between hospitals' performance on HQA quality indicators and mortality for Medicare enrollees admitted for acute myocardial infarction, congestive heart failure, and pneumonia. We found that higher condition-specific performance on this national quality reporting program is associated with lower risk-adjusted mortality for each of the three conditions. The relationship between high HQA performance and lower risk-adjusted mortality is an important validation for this national hospital quality rating program.