Medicaid to Cut Payment for 'Never Events'
The Centers for Medicare and Medicaid Services has given states until July 2012 to develop and implement payment policies that restrict Medicaid payments to hospitals and doctors for about two dozen "never events." The rule, published in early June, authorizes states to expand the payment prohibition to other conditions that could reasonably have been prevented by the application of evidence-based guidelines. According to Kaiser Health News, about 21 states have new payment policies in place. Hospitals have been required to submit information on Medicare claims specifying whether diagnoses were present on admission since October 2007.
Wellpoint Requires Proof of Quality for Hospital Pay Increases
Wellpoint Inc. announced it would cut off annual payment increases to hospitals that fail to meet the insurer's definition of quality patient care, the Wall Street Journal (WSJ) reported. In recent years, Wellpoint, which covers 34 million people, increased payments to hospitals by 8 percent, on average, each year. Under the new program, hospitals must qualify for additional payment based on 51 measures of treatment quality, including whether the hospital used a safety checklist and whether they took to steps to prevent readmissions. The formula is based on measures of health outcomes, patient safety, and patient satisfaction. In the WSJ article, Chip Kahn, president of the Federation of American Hospitals, argued that outcomes measures are not yet sophisticated enough to be used in such programs. Wellpoint said it has seen reductions in preventable admissions of 8 percent in hospitals that have voluntarily participated in the program. http://online.wsj.com/article/SB10001424052748704281504576325163218629124.html
AHRQ: Quality Improves, But Disparities Persist
In late May, the Agency for Healthcare Research and Quality released its 2010 State Snapshots http://statesnapshots.ahrq.gov/snaps10/index.jsp, which showed that health care quality has improved in many states, but disparities for minority and low-income residents persist. The results, which were summarized in ARHQ's National Healthcare Quality Report, 2010, and its National Healthcare Disparities Report, 2010, found that overall health care quality and access are suboptimal, especially for minority and low-income groups, and that progress is uneven with respect to end-of-life care, patient and family engagement, population health, safety, and access. New Hampshire, Maine, Massachusetts, Minnesota, and Rhode Island demonstrated the greatest overall performance improvement, while Kentucky, Louisiana, New Mexico, Oklahoma, and Texas had the small overall performance improvement. The report distinguishes quality by types of care, settings of care, and clinical conditions.
Hopkins to Create Center for Patient Safety
Johns Hopkins Medicine announced it will use a $10 million gift from the chairman of its board of trustees to establish an institute for patient safety and quality. The Armstrong Institute for Patient Safety and Quality will focus on eliminating preventable harm for patients, abolishing health disparities, ensuring clinical excellence, and creating a culture that values collaboration, accountability, and organizational learning.