A recent Kaiser Health News analysis found that 2,211 hospitals will be penalized starting in October because many of their patients are readmitted soon after discharge. Two-hundred and seventy-eight hospitals will lose the maximum allowed amount, or 1 percent of their Medicare reimbursements, for having what CMS considers to be "excess" readmissions. The penalties, which have been widely debated—in part because hospitals that treat more low-income patients tend to have higher readmission rates—are part of the Affordable Care Act's value-based purchasing efforts. Next to come: bonus payments for hospitals performing better than average, or showing improvement, on measures of quality and patient experiences.
Early this month, Massachusetts became the first state in the nation to pass legislation setting specific goals for controlling health care spending. The law—which aims to cut $200 billion from state budget over the next 15 years—ties the growth in health care spending to the growth in the state's economy, as measured by the gross state product. It also promotes new payment models and greater transparency through public reporting of quality and cost data, and creates a commission to track hospitals' and health plans' health care costs and levy fines on those that fail to meet cost control targets.
Are Hospitals Ready to Become ACOs?
A nationwide survey of nearly 1,700 hospitals finds that 13 percent are participating in, or planning to participate in, accountable care organizations (ACOs) in the next year. The Commonwealth Fund/Health Research and Educational Trust survey also found that hospitals already involved with ACOs are improving the coordination of patient care and doing a better job of ensuring safe transitions among care settings—both hallmarks of the ACO model. At the same time, the results show that hospitals will need to strengthen their capacity to undertake population-based care and to fully assume financial risk for the patient population for which they are accountable, the researchers say.
Hospital Initiative Leads to Better Care, Fewer Readmissions
A quality improvement network involving 100 hospitals across 16 U.S. communities led to reduced readmissions and shorter emergency department wait times, while improving adherence to recommended care. The hospitals, which shared best practices and lessons learned via monthly conference calls over 18 months in the Robert Wood Johnson's Aligning Forces for Quality program, chose which projects to focus on and filed progress reports to other members of the "virtual" improvement collaborative. Some 60 percent of the hospitals cut their readmissions among heart failure patients, while three-quarters improved heart failure care. Thirty-two of the hospitals created standardized systems for collecting data on patients' race, ethnicity, and preferred language.
Number of Board Certified Pharmacists Continues to Grow
There are now 13,000 board-certified pharmacists in the U.S.—an increase of 20 percent over 2011 and double the number from five years ago, according to the Board of Pharmacy Specialists. The Board assesses knowledge in six areas: ambulatory care, nuclear pharmacy, nutrition support, oncology, psychiatry, and pharmacotherapy. Board-certified pharmacists help manage medication regimens and ensure safe and effective treatment—work of critical importance, as more than half of Americans take at least one prescription medication, according to the announcement.