Shane Carrillo1, Niaman Nazir2, Eric Howser3, Lisa Shenkman4, Melinda Laxson3, Taenisha S Scheuermann2, Kimber P Richter2. 1. University of Kansas School of Medicine, University of Kansas Medical Center, Kansas City, KS. 2. Department of Preventative Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS. 3. Department of Organizational Improvement, University of Kansas Medical Center, Kansas City, KS. 4. Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, KS.
Abstract
INTRODUCTION: In its fiscal year 2015 final rule, the Centers for Medicare & Medicaid Services (CMS) required reporting of tobacco treatment quality measures as part of the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS). This pre-intervention, post-intervention policy analysis evaluates the impact of that policy at a large academic medical center that opted to improve performance as it implemented reporting measures. METHODS: Electronic medical record data were collected retrospectively for all adult (≥18 years) inpatient psychiatric admissions from January 1, 2014 to December 31, 2015. Data from admissions were analyzed to determine changes in the provision of tobacco treatment including the proportions of patients screened for tobacco use, receiving tobacco cessation counseling, and receiving tobacco cessation medication(s) using a chi-square test. Covariate analysis of treatment differences based on psychiatric diagnosis was analyzed using Cochran-Mantel-Haenszel and Breslow-Day test. RESULTS: Post-policy screening for admissions increased significantly (85% vs. 97%; p < .001). Referral to cessation counseling increased 18-fold (4% vs. 74%; p < .001). Receipt of Counselling (8% vs. 67%; p < .001) and referral for cessation medication (32% vs. 68%; p < .001) also increased dramatically. Though statistically non-significant, the number of tobacco users who actually received medications increased markedly between 2014 and 2015, 24% versus 35%. Gains in screening, referral, and treatment did not differ by psychiatric diagnosis. CONCLUSIONS: The Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program resulted in a 10-fold increase in the number of smokers who received inpatient tobacco treatment. Should CMS link prospective payment to performance, it could have a major impact on quality of care for tobacco dependence. IMPLICATIONS: This is the first study to examine the implementation and impact of new 2015 IPFQR program tobacco measures. This study may illustrate the potential effect that performance based penalties can have should facilities be required to do more than simply report on these tobacco measures. This study exemplifies the impact these new reporting measures can have when psychiatric facilities move beyond letter of the policy, to continually assess organizational performance and implement changes to improve treatment delivery.
INTRODUCTION: In its fiscal year 2015 final rule, the Centers for Medicare & Medicaid Services (CMS) required reporting of tobacco treatment quality measures as part of the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS). This pre-intervention, post-intervention policy analysis evaluates the impact of that policy at a large academic medical center that opted to improve performance as it implemented reporting measures. METHODS: Electronic medical record data were collected retrospectively for all adult (≥18 years) inpatient psychiatric admissions from January 1, 2014 to December 31, 2015. Data from admissions were analyzed to determine changes in the provision of tobacco treatment including the proportions of patients screened for tobacco use, receiving tobacco cessation counseling, and receiving tobacco cessation medication(s) using a chi-square test. Covariate analysis of treatment differences based on psychiatric diagnosis was analyzed using Cochran-Mantel-Haenszel and Breslow-Day test. RESULTS: Post-policy screening for admissions increased significantly (85% vs. 97%; p < .001). Referral to cessation counseling increased 18-fold (4% vs. 74%; p < .001). Receipt of Counselling (8% vs. 67%; p < .001) and referral for cessation medication (32% vs. 68%; p < .001) also increased dramatically. Though statistically non-significant, the number of tobacco users who actually received medications increased markedly between 2014 and 2015, 24% versus 35%. Gains in screening, referral, and treatment did not differ by psychiatric diagnosis. CONCLUSIONS: The Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program resulted in a 10-fold increase in the number of smokers who received inpatient tobacco treatment. Should CMS link prospective payment to performance, it could have a major impact on quality of care for tobacco dependence. IMPLICATIONS: This is the first study to examine the implementation and impact of new 2015 IPFQR program tobacco measures. This study may illustrate the potential effect that performance based penalties can have should facilities be required to do more than simply report on these tobacco measures. This study exemplifies the impact these new reporting measures can have when psychiatric facilities move beyond letter of the policy, to continually assess organizational performance and implement changes to improve treatment delivery.
Authors: Peter K Lindenauer; Denise Remus; Sheila Roman; Michael B Rothberg; Evan M Benjamin; Allen Ma; Dale W Bratzler Journal: N Engl J Med Date: 2007-01-26 Impact factor: 91.245
Authors: Sonia A Duffy; David L Ronis; Carrie A Karvonen-Gutierrez; Lee A Ewing; Stephanie V Hall; James J Yang; Patricia L Thomas; Christine M Olree; Kimberly A Maguire; Lisa Friedman; Donna Gray; Neil Jordan Journal: Am J Prev Med Date: 2016-10 Impact factor: 5.043
Authors: Su Fen Lubitz; Alex Flitter; E Paul Wileyto; Douglas Ziedonis; Nathaniel Stevens; Frank Leone; David Mandell; John Kimberly; Rinad Beidas; Robert A Schnoll Journal: Nicotine Tob Res Date: 2020-08-24 Impact factor: 4.244
Authors: Mackenzie Hosie Quinn; Matthew Olonoff; Anna-Marika Bauer; Erica Fox; Nancy Jao; Su Fen Lubitz; Frank Leone; Jacqueline K Gollan; Robert Schnoll; Brian Hitsman Journal: Nicotine Tob Res Date: 2022-01-01 Impact factor: 5.825