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Partnership for Patients to Improve Care, Lower Costs Introduced by Obama Administration

Potential savings of $50 billion for Medicare plus billions for Medicaid by improving hospital care

April 12, 2011 – The Obama administration today announced the Partnership for Patients, a national partnership aimed at saving $35 billion in health care costs – up to $10 billion for Medicare – and saving 60,000 lives by stopping millions of preventable injuries and complications in patient care over the next three years.

Over the next ten years, the Partnership for Patients could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings, according to the announcement by Health and Human Services Secretary Kathleen Sebelius.

She was joined by leaders of major hospitals, employers, health plans, physicians, nurses, and patient advocates. More than 500 hospitals, as well as physicians and nurses groups, consumer groups, and employers have already pledged their commitment to the new initiative.

 

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“Americans go the hospital to get well, but millions of patients are injured because of preventable complications and accidents,” said Secretary Sebelius.  “Working closely with hospitals, doctors, nurses, patients, families and employers, we will support efforts to help keep patients safe, improve care, and reduce costs. Working together, we can help eliminate preventable harm to patients.”

To launch this initiative, HHS announced it would invest up to $1 billion in federal funding, made available under the Affordable Care Act.  Today, $500 million of that funding was made available through the Community-based Care Transitions Program.  Up to $500 million more will be dedicated from the Centers for Medicare & Medicaid Services (CMS) Innovation Center to support new demonstrations related to reducing hospital-acquired conditions. 

The funding will be invested in reforms that help achieve two shared goals:

    1.  Keep hospital patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40-percent compared to 2010.  Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years. 

    2.  Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20-percent compared to 2010.  Achieving this goal would mean more than 1.6 million patients will recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.

Will Focus on Nine Types of Medical Errors and Complications

The Partnership will target all forms of harm to patients but will start by asking hospitals to focus on nine types of medical errors and complications where the potential for dramatic reductions in harm rates has been demonstrated by pioneering hospitals and systems across the country.  Examples include preventing adverse drug reactions, pressure ulcers, childbirth complications and surgical site infections.

The CMS Innovation Center will help hospitals adapt effective, evidence-based care improvements to target preventable patient injuries on a local level, developing innovative approaches to spreading and sharing strategies among public and private partners in all states.  Members of the partnership will identify specific steps they will take to reduce preventable injuries and complications in patient care. 

“With new tools provided by the Affordable Care Act, we can aggressively implement programs that will help hospitals reduce preventable errors,” said CMS Administrator Donald Berwick, M.D.  “We will provide hospitals with incentives to improve the quality of health care, and provide real assistance to medical professionals and hospitals to support their efforts to reduce harm.” 

Community-based Organizations Can Apply

HHS has committed $500 million to community-based organizations partnering with eligible hospitals to help patients safely transition between settings of care.  Today, community-based organizations and acute care hospitals that partner with community-based organizations can begin submitting applications for this funding.  Applications are being accepted on a rolling basis.  Awards will be made on an ongoing basis as funding permits.

CMS Innovation Center Targets Patient Safety

In coordination with stakeholders from across the health care system, the CMS Innovation Center is planning to use up to $500 million in additional funding to test different models of improving patient care and patient engagement and collaboration in order to reduce hospital-acquired conditions and improve care transitions nationwide.   These collaborative models will help hospitals adopt effective interventions for improving patient safety in their facilities. 

The programs announced today are just two of the many ways the Affordable Care Act is helping improve the health care system.  Last month, HHS announced the first-ever National Quality Strategy, which will serve as a tool to help coordinate quality initiatives between public and private partners as well as to leverage and coordinate existing efforts by federal agencies and departments to improve patient care.  

Accountable Care Organizations (ACOs) to Coordinate Care

HHS also announced new rules to help doctors, hospitals, and other providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).  By 2015, a portion of Medicare payments to the majority of hospitals will be linked to whether hospitals are delivering safer care, using information technology effectively and meeting patient needs.  Payment incentives and supports to improve quality and lower costs will also be available to state Medicaid programs.

“No single entity can improve care for millions of hospital patients alone,” said Berwick.  “Through strong partnerships at national, regional, state and local levels – including the public sector and some of the nation’s largest companies – we are supporting the hospital community to significantly reduce harm to patients.”

Consumers Union Wants Hospitals Held Accountable

The initiative represents an important effort to make patient safety a priority and sets goals to reduce medical harm, according to Consumers Union, the nonprofit publishers of Consumer Reports. But the group noted that more emphasis is needed on holding individual hospitals accountable for reducing medical harm through mandatory public reporting of each hospital’s performance.

“We’ve known for years that millions of Americans are unnecessarily harmed in the hospital every year from preventable infections and other medical errors,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project (www.safepatientproject.org).

“A high-profile, coordinated, national response to our patient safety crisis is long overdue.  We are encouraged that the Obama administration is making patient safety a national priority.  Public reporting of each hospital’s patient safety track record is the best way to measure whether this effort is successful.”¯

Consumers Union Poll Shows High Public Concern About Medical Errors

Consumers Union recently released the results of a new national poll by the Consumer Reports National Research Center that found high levels of public concern about medical errors.  The poll found that 77 percent of respondents expressed high or moderate concern that they or someone in their family might be harmed by a hospital infection during treatment in the hospital.  Seventy-one percent expressed high or moderate concern about being harmed by a medication error, and 65 percent were similarly concerned about surgical errors.

Only 17 percent of respondents indicated that they thought their doctor or other hospital staff would always inform them when a medical error was made during treatment even though 97 percent always wanted to be informed.  Forty-seven percent said that they expected to be informed rarely or never when medical errors occurred.

Almost Everyone Says Hospitals Should Be Required to Report Errors

Virtually all consumers - 96 percent - said that hospitals should be required to report medical errors to state health departments, and 82 percent wanted each hospital’s medical error record to be available to the public. 

13.5% of Medicare Patients Experience Infections, Harm in Hospitals

Recent research has found that hospital infections and other medical harm are even more common than previously estimated.  A November 2010 study by the Department of Health and Human Services’ Office of the Inspector General found that one in seven Medicare patients or 13.5 percent experienced serious or long term medical harm (including infections) or death while they underwent treatment in the hospital. 

Another 13 percent of patients experienced temporary harm.  The researchers estimated that hospital infections and medical errors involving Medicare patients contributed to approximately 180,000 deaths and $4.4 billion in additional hospital care costs each year.

CDC Finds Two Million Americans Suffer Hospital Acquired Infections

Separately, the Centers for Disease Control and Prevention has found that nearly two million Americans suffer from hospital acquired infections every year.  These infections result in as much as $45 billion in extra hospital care.  Patients who develop hospital infections and other complications often require longer stays in the hospital or end up being readmitted for further treatments.  Almost one in five Medicare patients who are discharged from the hospital are readmitted within 30 days.

Likewise, a November 2010 New England Journal of Medicine study in North Carolina hospitals found that one in four patients were harmed by the care they received, ranging from hospital acquired infections, surgical errors, and medication dosage mistakes. 

Other medical errors include serious bed sores, patient falls in the hospital from inattentive care, and diagnostic mistakes.  The study, which covered a six-year period, found no significant improvement in patient safety. 

Health Affairs Finds 90% of Hospital Mistakes Overlooked

Another report issued by Health Affairs last week indicated that as many as 90 percent of hospital mistakes were overlooked.  Under the national initiative, hospitals participating in Medicare and Medicaid programs will be required to meet certain patient safety standards and efforts to reduce patient harm will be emphasized in the certification process.

The Partnership for Patients seeks to reduce hospital-acquired conditions by 40 percent by the end of 2013 compared to 2010.  It aims to reduce preventable complications so that all hospital readmissions are reduced by 20 percent by the end of 2013 compared to 2010. 

Under the Partnership, the federal government will provide resources to encourage hospitals to implement strategies to improve patient safety and partner with the private sector on using incentives to enhance the quality and safety of care.     

News Reports on Partnership for Patients

   ● ABC News: "Health and Human Services Secretary Kathleen Sebelius today announced a national program to help save 63,000 lives and up to $35 billion in health care costs over the next three years by preventing hospital-related injuries. ... Sebelius said under the Partnership for Patients, HHS would invest up to $1 billion in federal funding through the Affordable Care Act." The partnership's two main goals are "[t]o reduce preventable injuries by 40 percent; and cut preventable hospital readmissions by 20 percent" (Moisse, 4/12).

   ● Modern Healthcare: The "$1 billion collaborative patient-safety initiative [is] focused on reducing preventable harm and easing transitions of care. ... 'With new tools provided by the Affordable Care Act, we can aggressively implement programs that will help hospitals reduce preventable errors,' CMS Administrator Dr. Donald Berwick said in a news release. 'We will provide hospitals with incentives to improve the quality of healthcare, and provide real assistance to medical professionals and hospitals to support their efforts to reduce harm'" (McKinney, 4/12). 

   ● Fox News: "HHS says more than 500 hospitals have already signed on to be a part of the partnership that focuses on teamwork instead of blame to cut down on medical mistakes and make patient care safer. Advocates say Medicare will be a key to the partnership's success. ... But the plan's parameters could be in jeopardy going forward. House Republicans have introduced a 2012 budget that would, in essence, end Medicare, and earlier this year, voted to repeal the Affordable Care Act. And critics of the plan suggest the federal government shouldn't get into a free-market issue when the hasn't been a free-market failure" (Barrett, 4/12).

   ● The Hill: "More than half of Americans believe the quality of U.S. healthcare is average at best, a new poll finds. Fifty-fifty percent gave healthcare quality a C or D grade on a typical report card scale, and 11 percent said the system completely flunks out, according to a survey from the Robert Wood Johnson Foundation. ... The Tuesday morning report comes out as the Department of Health and Human Services unveiled a new patient safety initiative that seeks to improve healthcare quality while producing up to $50 billion in Medicare savings" (Millman, 4/12).

Some of this information is reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

For more information about the Partnership for Patients, visit www.HealthCare.gov/center/programs/partnership.  For a fact sheet on today’s announcement, visit www.HealthCare.gov/news/factsheets/partnership04122011a.html.  For more information about the Community-based Care Transitions Program funding opportunity, visit www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1239313.

 

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