Administrative Memos

200303

FROM: Theodore O. Will, Chief Executive Officer
DATE: Feb 27, 2003
SUBJECT: Medicaid Congestive Heart Failure New York Statewide Impact Report
IPRO CONTACTS:

Charles Stimler, M.D., M.P.H., Medical Officer, extension 634
Marguerite Shaffer, R.N., C.P.H.Q., Senior Director, extension 634

The enclosed report, "Medicaid Congestive Heart Failure (CHF) New York Statewide Impact Report," provides current information on the quality of care being provided in hospitals for Medicaid patients with heart failure. Congestive heart failure (CHF) is a very common primary discharge diagnosis and accounts for an estimated $20.2 billion cost burden to the health care system nationwide. Improving the quality of care for CHF can translate into fewer unnecessary admissions and lower costs.

Quality indicators studied included the appropriate use of angiotensin converting enzyme inhibitors (ACEIs) for patients without contraindications, the measurement of left ventricular ejection fraction (EF), and the provision of discharge instructions to patients prior to leaving the hospital. The report provides information on a sample of inpatient medical records for Medicaid patients who were discharged between December 1, 2001 and February 28, 2002 and compares these quality indicator values with those of a similar sample of Medicaid patients discharged between January 1, 1999 and March 31, 1999. The report also compares Medicaid quality indicator values with those of a recently sampled Medicare population.

Among the important findings was that while there was no discernible improvement in the rate of ACEI use over the past 2 years, the use of Beta Blockers for CHF has increased considerably. In addition, the quality indicator rates for all discharge instructions documented and smoking cessation instructions documented are currently quite low and have a great opportunity for improvement.

We hope that this report will be helpful to hospitals in further developing their quality improvement programs and in assessing the need for interventions to raise the levels of quality for their CHF Medicaid population.

Should you have any questions regarding this report or this memorandum, please contact either Marguerite Shaffer or Dr. Charles Stimler at 516-326-7767, extension 634.