CMS awards $347 million to continue progress toward a safer health care system
Hospital Improvement and Innovation Networks to continue patient safety improvement efforts started under the Partnership for Patients initiative
The Centers for Medicare & Medicaid Services (CMS) awarded $347 million to 16 national, regional, or state hospital associations, Quality Improvement Organizations, and health system organizations to continue efforts in reducing hospital-acquired conditions and readmissions in the Medicare program. The Hospital Improvement and Innovation Network contracts awarded today build upon the collective momentum of the Hospital Engagement Networks and Quality Improvement Organizations to reduce patient harm and readmissions. This announcement is part of a broader effort to transform our health care system into one that works better for the American people and for the Medicare program. The Administration has a vision of a system that delivers better care, spends our dollars in a smarter way, and puts patients in the center of their care to keep them healthy.
“We have made significant progress in keeping patients safe – an estimated 2.1 million fewer patients harmed, 87,000 lives saved, and nearly $20 billion in cost-savings from 2010 to 2014 – and we are focused on accelerating improvement efforts,” said Patrick Conway, M.D., CMS acting principal deputy administrator and chief medical officer. “The work of the Hospital Improvement and Innovation Networks will allow us to continue to improve health care safety across the nation and reduce readmissions at a national scale – keeping people as safe and healthy as possible.”
“America’s hospitals embrace the ambitious new goals CMS has proposed,” said Rick Pollack, president and CEO of the American Hospital Association (AHA). “The vast majority of the nation’s 5,000 hospitals were involved in the successful pursuit of the initial Partnership for Patients aims. Our goal is to get to zero incidents. AHA and our members intend to keep an unrelenting focus on providing better, safer care to our patients -- working in close partnership with the federal government and with each other.”
Building on this shared success, new, ambitious goals have been set for the Hospital Improvement and Innovation Networks. Through 2019, these Hospital Improvement and Innovation Networks will work to achieve a 20 percent decrease in overall patient harm and a 12 percent reduction in 30-day hospital readmissions as a population-based measure (readmissions per 1,000 people) from the 2014 baseline.
The establishment of these new goals raises the bar for improvements in patient safety in the acute care hospital setting. The newly identified goal of a 20 percent reduction in all-cause patient harm will continue the strong momentum in improving the quality of care delivered to Medicare patients. The goal for harm reduction set forth during the initial phases of Partnership for Patients periods was to decrease preventable patient harm by 40 percent. These efforts resulted in a 39 percent decrease in preventable all-cause harm compared to a 2010 baseline rate of 145/1000, which equated to a 17 percent reduction in overall harm. The even more ambitious goal of a 20 percent reduction in overall harm is based on a 2014 baseline of 121 harms/1000 and aims to achieve a rate of 97 harms/1000 by the end of 2019.
Debra L. Ness, President of the National Partnership for Women & Families, applauded the new awards: “Patients and families will benefit immensely from the continuation of the Partnership for Patients’ important work, which was begun in the CMS Innovation Center. Innovative approaches to systematically include patients and families in this intensive improvement work have resulted in unprecedented national reductions in harm. We are confident that the more ambitious aims being announced today – and the continued engagement of patients and families in this work – will continue the progress.”
Expanding the focus for the Hospital Improvement and Innovation Networks to include a reduction in all-cause patient harm supports the development of an overall culture of safety in the nation’s hospitals by creating an environment that supports a high quality, patient-centered approach to care delivery.
Hospital Improvement and Innovation Networks will also work to expand and develop learning collaboratives for hospitals and provide a wide array of initiatives and activities to improve patient safety in the Medicare program. They will be required to address a wide variety of topics, including:
- Adverse drug events (to focus on at least the following three medication categories: opioids, anticoagulants, and hypoglycemic agents)
- Central line-associated blood stream infections (in all hospital settings)
- Catheter-associated urinary tract infections (in all hospital settings)
- Clostridium difficile infection (including antibiotic stewardship)
- Injury from falls and immobility
- Pressure Ulcers
- Sepsis and Septic Shock
- Surgical Site Infections (for multiple classes of surgeries)
- Venous thromboembolism (at a minimum in all surgical settings)
- Ventilator-Associated Events
- Readmissions
Efforts to address health equity for Medicare beneficiaries will be central to the Hospital Improvement and Innovation Networks efforts. CMS will monitor and evaluate the activities of the Hospital Improvement and Innovation Networks to ensure that they are generating results and improving patient safety.
The 16 organizations (listed in alphabetical order) receiving contracts in the Hospital Improvement and Innovation Networks are:
- Carolinas Healthcare System
- Dignity Health
- Healthcare Association of New York State
- HealthInsight
- The Health Research and Educational Trust of the American Hospital Association
- Health Research and Educational Trust of New Jersey
- Health Services Advisory Group
- The Hospital and Healthsystem Association of Pennsylvania
- Iowa Healthcare Collaborative
- Michigan Health & Hospital Association (MHA) Health Foundation
- Minnesota Hospital Association
- Ohio Children’s Hospitals’ Solutions for Patient Safety
- Ohio Hospital Association
- Premier, Inc.
- Vizient, Inc.
- Washington State Hospital Association
The Partnership for Patients model is one of the first models established in 2011 to be tested under the authority of section 1115A of the Social Security Act (the Act) with the goal of reducing program expenditures while preserving or enhancing the quality of care. Since the launch of the Partnership for Patients and the work of Hospital Engagement Networks in collaboration with many other stakeholders, the vast majority of U.S. hospitals have delivered results as demonstrated by the achievement of unprecedented national reductions in harm. CMS believes that the upcoming work of the Hospital Improvement Innovation Networks, working as part of the Quality Improvement Organization’s work to improve patient safety and the quality of care in the Medicare program, will continue the great strides made in improving care provided to beneficiaries.
For more information on this announcement, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-09-29-2.html.
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