Thursday, 17 December 2015 05:47

Providers Achieving Varying Degrees of Success in Reducing HACs

Written by Mark Spivey

Deaths due to hospital-acquired conditions (HACs) have been declining precipitously during the current decade, according to an Agency for Healthcare Research and Quality (AHRQ) report released earlier this month, although the number of providers participating in the federal HAC Reduction Program that exhibited sub-optimal performance rose slightly during the 2016 fiscal year, the Centers for Medicare & Medicaid Services (CMS) noted a week later.

The mixed results were announced as providers nationwide continue to make reduction of HACs a top priority closely tied to an overarching emphasis on value-based purchasing, or VBP.

First, a closer look at the good news: the AHRQ’s report clearly indicates that “the chances that you will receive safer care when you enter the hospital are increasing” nationwide, according to a Dec. 3 post on the AHRQ blog penned by Jeff Brady, director of AHRQ's Center for Quality Improvement and Patient Safety.

“Between 2010 and 2014, we estimate that 87,000 fewer patients died from … (HACs) such as adverse drug events, pressure ulcers, and potentially dangerous infections. In 2014 alone, 37,000 fewer patients died than would have died if the rate of adverse events had remained at the 2010 level,” Brady wrote. “That is approximately equal to the number of women who die from breast cancer in the United States each year.”

The incidence of these events overall has been reduced by 2.1 million, yielding an estimated savings of $19.8 billion, the blog post indicated.  The new data, Brady said, builds on data that AHRQ released last year that showed HAC rates declining by 17 percent between 2010 and 2013.

“Of course, providing safer patient care is a goal shared by all of us who care for, and care about, patients. But the hard work of reducing and sustaining declines in HACs required ongoing involvement from the public and private sector, including Medicare payment incentives, hospital-based electronic health records, education and outreach, and evidence-based tools to implement best practices,” Brady wrote, specifically pointing to Medicare payment incentives written into the Patient Protection and Affordable Care Act of 2010.

Following passage of the Act, the U.S. Department of Health and Human Services (HHS) created the Partnership for Patients, a public-private initiative focused on making care safer, more reliable, and more affordable, Brady added, noting that at the outset of the initiative, AHRQ helped coordinate the development and use of a national measurement strategy, which is the baseline for the organization’s report.

“Not only has the national reduction in HACs saved lives and saved money, it has helped policymakers and health providers recognize the magnitude of what can be achieved,” the blog post read. “Providers have learned what they need to do to prevent patient harm, while HHS and its partner agencies have identified how best practices can most effectively be put into widespread practice.”

The CMS report outlining details about the federal HAC Reduction Program was less optimistic in tone. That Program also was established as a provision of the PPACA – effective for discharges occurring on and after Oct. 1, 2014, it requires HHS to adjust payments to applicable hospitals that rank in the worst-performing quartile of all participating hospitals with respect to risk-adjusted HAC quality measures.

Specifically, such hospitals have their payments reduced by 1 percent. A total of 724 hospitals took such a payment hit during the 2015 fiscal year, while 758 (out of more than 3,300 in all) did so for the 2016 fiscal year, resulting in federal savings of $364 million.

Still, it wasn’t all bad news coming from CMS in its report, which was dated Dec. 10.

“Across the FY 2015 and FY 2016 programs, the average performance across eligible hospitals improved on two of the three measures included in both program years,” the agency noted.

All of the 2016 HAC Reduction Program scores for hospitals can be reviewed online at the Hospital Compare website, specifically on the following link: https://www.medicare.gov/hospitalcompare/HAC-reduction-program.html. The list of hospitals subject to the payment adjustments are posted on the CMS.gov website under this link: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html.

Certainly, there is more work to be done,” Brady wrote in his blog post – foreshadowing the news that came a week later. “The report we just released shows that there were 121 adverse events in 2014 for every 1,000 hospitalizations, a rate that is still too high. And following big declines in that rate in 2012 and 2013, the rate plateaued from 2013 to 2014, emphasizing the need for redoubling our collective efforts.”

“But this report shows that we’re moving in the right direction,” he concluded. “We are eager to continue working with our colleagues within HHS and with hospitals across the country to ensure that (the proper) resources are put to use on the front lines of care.”

Mark Spivey is a national correspondent for VBPmonitor.com. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

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Last modified on Friday, 18 December 2015 05:48