HHS tests new quality program
Coordinate care, save money
A new program announced in July by the US Department of Health and Human Services (HHS) aims to help states improve quality of care and share in any cost savings through improved coordination.
The new plan has two different models. In the first, a state and a health plan can enter a partnership with the Centers for Medicare & Medicaid Services (CMS) where the managed care plan gets a payment to provide comprehensive coordinated care. The second allows the state and CMS to have a contract where the state could benefit from savings resulted from managed fee-for-service initiatives that are designed to improve quality and reduce costs.
Both models will undergo testing to see if they save money while at least preserving quality of care for Medicare and Medicaid patients. Any state that meets standards and conditions can adopt either or both models.
HHS also announced an initiative for nursing facility patients that aims to prevent hospitalizations among them. The goal is to get them the care they need without sending them to the hospital. A 2005 study found that 40% of hospital admissions among this population were preventable. Doing so could save some $2.6 billion.
The program will allow CMS to "competitively select" organizations to partner with nursing facilities and implement interventions. They might be QI programs to prevent falls or pressure ulcers, or using midlevel practitioners to support transitions between hospitals and nursing facilities.
Hospitals back Partnership for Patients
More than 2,000 of the nation's hospitals including every facility in the state of Iowa has signed onto the Partnership for Patients safety initiative sponsored by the Obama administration.
The goal of the program is to reduce preventable harm in hospitals by 40% in the next three years, including reductions in central line-associated bloodstream infections, falls and other injuries, and in-hospital medication errors. The partnership also has a goal of reducing 30-day readmission rates by 20% over the same time period.
The potential savings from the initiatives is $35 billion, including $10 billion for Medicare. More information about the program is available at http://www.healthcare.gov/partnershipforpatients
NCQA adds new measures to HEDIS
The National Committee for Quality Assurance is making changes to the Healthcare Effectiveness Data and Information Set (HEDIS), Volume 2, adding two new measures and retiring an old one. The organization is also aligning its submission date for Medicare with the Medicaid commercial HEDIS submission date, June 15, 2012. This is at the request of the Centers for Medicare & Medicaid Services (CMS).
The two new measures in the HEDIS 2012, Volume 2 are:
- Human Papillomavirus Vaccine for Female Adolescents This measure assesses the percentage of 13-year-old females who had three doses of the human papillomavirus (HPV) vaccine. The measure evaluates compliance with Centers for Disease Control and Prevention and Advisory Committee on Immunization Practices immunization guidelines.
- Medication Management for People With Asthma This measure assesses the percentage of people 5–64 years of age who were identified as having persistent asthma and who received and remained on appropriate medications during their treatment period.
The measure that is being retired is Relative Resource Use for People With Acute Low Back Pain. You can order the new volume at the NCQA website, www.ncqa.org/publications.
Joint Commission adds episode to Speak Up
The fifth in the series of Speak Up videos is out at the Joint Commission. This one, entitled Speak Up: Kid Power, is geared toward pediatric facilities and encourages children to feel good about asking questions about their healthcare.
The series of 60-second videos is on the Joint Commission's YouTube channel, where nearly 14,000 users have viewed them. There are also brochures and posters available for the Speak Up program, which urges patients to take a more active role in preventing health care errors.
Materials from the program are available free at the Joint Commission website, including Spanish language versions of the brochures.