While most of the attention surrounding the landmark healthcare reform measure just signed into law has focused on how it expands access to affordable insurance coverage, it also enacts important initiatives that will improve patient safety, according to Consumers Union, the nonprofit publisher of Consumer Reports.
“Millions of Americans are harmed every year by medical errors and healthcare acquired infections that are preventable,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project (www.SafePatientProject.org). “The new healthcare reform law will save lives and dollars by arming consumers with information about each hospital’s patient safety record and leveraging federal healthcare dollars to give hospitals a stronger incentive to prevent needless suffering and deaths. More reforms are needed to protect patients from preventable medical harm, but the new law creates a solid foundation that will help to ensure that the healthcare we are paying for is safe.”
The Institute of Medicine estimated in 1999 that as many as 98,000 Americans die every year from medical errors. The number is undoubtedly much higher since the Centers for Disease Control and Prevention (CDC) has subsequently estimated that almost 100,000 Americans die from hospital-acquired infections alone. The CDC estimates that hospital acquired infections add as much as $45 billion to hospital costs paid each year by taxpayers, insurers, and consumers.
The new healthcare reform law refers to medical harm in many different ways – hospital-acquired conditions, medical errors, healthcare-associated infections. The new law aims to improve patient safety by:
-- Paying hospitals for improving care, including reducing hospital-acquired infections: Hospitals currently are paid more under Medicare if they report how well they follow practices that improve the quality of patient care (for example, procedures shown to reduce the incidence of surgical infections). Beginning in October 2012, non-rural acute care hospitals that meet or exceed performance standards established by the Secretary of Health and Human Services (HHS) for at least five measures will receive higher Medicare payments from a pool of money collected from all hospitals. These measures must include certain hospital-acquired infections listed under a federal infection prevention action plan. [HR 3590, Title III, Subtitle A, Sec 3001, p. 235]
-- Reducing costly hospital readmissions: The new law requires HHS to calculate the actual and predicted readmission rates to hospitals for several different health conditions that are associated with a high number of readmissions or high costs (such as heart failure or pneumonia). Patients who develop hospital-acquired infections and other complications often have to be readmitted to the hospital for additional costly care. Starting in October 2012, hospitals with high readmission rates for patients with these conditions will have their Medicare payments reduced. In 2014, HHS must expand this policy to cover four additional health conditions. Each hospital’s readmission track record for these conditions will be published. The Congressional Budget Office (CBO) estimates that this provision will save $7 billion over the next ten years. [HR 3590, Title III, Subtitle A, Sec 3025, p. 290]
-- Restricting Medicaid payments when hospitals harm patients: The federal government already restricts Medicare payments to hospitals for the extra care required to treat Medicare patients harmed by certain preventable infections and medical errors, known as “hospital-acquired conditions” (for example, serious bed sores, catheter associated urinary tract infections and certain types of falls and trauma). The new law expands this policy to Medicaid so critical public funds will no longer pay hospitals when patients covered by Medicaid are harmed during their hospital stay. [HR3590, Title II, Subtitle I, Sec 2702, p. 200]
