Cheers, qualms over value-based purchasing
The CMS unveils its hospital valuebased purchasing program, which rewards hospitals for their performance on selected measures. The program, first proposed in January, draws praise for its focus on quality but also sparks protest among many providers, who worry about the weight given to patient-satisfaction scores and about penalties for hospital-acquired infections.
In July, three months after the initial rule is finalized, the CMS issues additional proposed changes to the program for 2014, released along with the agency’s proposed rule for outpatient reimbursement. The agency’s addition of an efficiency measure, which rewards or penalizes hospitals based on their per-patient Medicare spending, draws ire from provider groups, including the American Hospital Association, which argues the measure is not endorsed by the National Quality Forum.
In November, the CMS responds to provider comments, omitting hospitalacquired conditions from the program for 2014, and giving hospitals more breathing room on the efficiency measure.
HHS releases its National Strategy for Quality Improvement in Health Care, which provides a broad framework to cut healthcare costs, improve population health and promote quality. Initial priorities include engaging patients and families, coordinating care, and addressing leading causes of mortality.
The nation’s level of overall healthcare quality is up slightly— particularly in preventive services and treatment of acute illnesses— but racial, ethnic and socioeconomic disparities persist, according to the 2010 National Healthcare Quality and Disparities Reports, released in March by HHS’ Agency for Healthcare Research and Quality.
HHS unveils the Partnership for Patients, a $1 billion public-private initiative aimed at reducing preventable hospital readmissions and lowering rates of hospital-acquired conditions. HHS predicts the program will save as many as 60,000 lives over the next three years and as much as $50 million over the next decade.
Rates of central line-associated bloodstream infections have fallen 58%, from 43,000 in 2001 to 18,000 in 2009, the Centers for Disease Control and Prevention says in a March report. The agency credits the drop to use of evidence-based practices and improved surveillance.
A study published in the April issue of Health Affairs finds that the number of adverse events in hospitals could be as many as 10 times higher than previous estimations.
In the face of provider criticism, the CMS publishes a file on its Hospital Compare website containing facility-specific data on hospital-acquired conditions.
The NQF updates its list of serious reportable events for the first time in five years, adding four new events and addressing patient safety outside of hospital settings.
The National Committee for Quality Assurance releases its annual State of Health Care Quality 2011 Report, showing overall improvements in quality across health plans in areas such as chronic disease management and preventable hospital readmissions.