quality of care

Survey says: Hospitals not treating pain sufficiently

Anne Zieger — Fri, 31 Oct 2008 11:08:37 -0400

Hospitals are not treating pain as well as they could, says a new survey out today from the New England Journal of Medicine. The survey, which was done in hospitals from 40 major metropolitan areas, showed that nearly one-third of patients felt that their pain relief was not sufficient. Yet modern medicine can relieve nearly all pain.

What are the reasons for this discrepancy? For one, in spite of 76 million Americans living in chronic pain, medical schools give only a one hour training session on understanding and dealing with pain in their patients. Further, there are very few pain specialists even though pain management is a widespread problem.

And even though an estimated three-quarters of people over the age of 65 suffer from chronic pain, only 2 percent of NIH funds go toward pain research.

To learn more about the survey results:
- read this McClatchy-Tribune piece

Health plan quality improves, while federal payers lag

Anne Zieger — Fri, 03 Oct 2008 14:36:25 -0400

Over the last nine years, the quality of care delivered to patients enrolled in health plans submitting data to the National Committee for Quality Assurance has continued to improve, though federal payers are lagging behind, according to a new NCQA report. The NCQA accredits and measures health plans using a list of clinical measures tracking how often appropriate care is delivered. Nearly half of 202 million Americans in the commercial insurance market are enrolled in plans that measure quality and report to the NCQA. Data for this year's report came from 2007 and tracked 845 plans.

According to the report, commercial plans that submitted HEDIS data (Healthcare Effectiveness Data and Information Set) showed increases on 44 of 54 quality measures, including asthma med management, blood pressure control and postpartum care for infants. Private Medicare plans also showed improvements, including in management of medications and treatment after heart attacks. However, traditional Medicare plans only showed improvement for 24 of 45 measures, and Medicaid on 26 of 52.

To learn more about the report:
- read this Modern Healthcare article (reg. req.)

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11 more communities tapped by HHS collaborate to share quality, price info

Anne Zieger — Fri, 05 Sep 2008 09:53:37 -0400

Joining 14 communities already participating in the program, 11 new communities have been named by HHS as Chartered Value Exchanges, collaboratives focused on improving care quality, and sharing quality and price data freely. This round of exchanges will be based in several cities acrsoss the U.S., including York, PA; San Francisco; Denver; Middletown, CT; Louisville; Cincinnati; Kansas City and Glen Allen, VA. The Chartered Value Exchange participants will get information from Medicare measuring quality of care that physicians provide to patients. The groups will possibly use the Medicare data in tandem with private sector data to produce a more comprehensive guide to quality of care in their communities. Other communities can still apply to become CVEs, but they only have between Sept. 15 and Oct. 30, 2008.

To learn more about this program:
- read this Healthcare Finance News piece

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Study: Majority of patients want EMRs

Anne Zieger — Fri, 08 Aug 2008 10:44:56 -0400

A new study from the Commonwealth Fund suggests that the majority of patients would like to see doctors move to electronic medical records, with many suggesting that EMRs would help to improve care quality and improve care coordination within the healthcare system as a whole. The study, which was conducted by Harris Interactive, found that almost 90 percent of respondents want their doctors to be able to share data electronically with other practices or hospitals. Meanwhile, another 71 percent of patients responding said that they want their doctors to be able to use e-prescribing technology to order their prescriptions.

While patients came out strongly in favor of physicians using technology for their care, they were less emphatic when it came to their own part in the process. A comparatively modest 44 percent said that they'd access their own medical records over the internet if available. Forty-eight percent said they'd book appointments and e-mail their doctors if they could. (Right now, only 8 percent were able to book appointments online, and 18 percent had e-mail access to their doctors.)

To learn more about this study:
- read this Modern Healthcare piece (reg. req.)

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CMS will pay more than $36M in quality reporting

Anne Zieger — Wed, 16 Jul 2008 13:36:57 -0400

CMS has announced that it will pay out more than $36 million in incentives money to providers who reported data on quality of care delivered between July 2007 and December 2007 as part of its Physician Quality Reporting Initiative. Under the PQRI, health providers who choose to participate get bonuses of 1.5 percent of their total CMS payments during the reporting period in which they reported quality data. Average payments for the most recent period range from $600 for individual physicians to $4,700 for groups. The largest payment CMS plans to make to a practice is more than $205,700. Health professionals in the states of Florida and states with the largest payouts are getting $5 million of the total, the agency said.

To learn more about PQRI payouts:
- read this Kaiser Daily Health Policy Report item

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FL will post preventable readmissions on website

Anne Zieger — Mon, 30 Jun 2008 23:05:40 -0400

In their own unusual take on transparency, Florida officials have decided to post data on potentially preventable hospital readmissions on the Web. The Florida Agency for Health Care Administration will post the data on its consumer-facing Web site, FloridaHealthFinder.gov. The data is intended not only to aid officials in tracking the rate of such relapses, but also to help hospital administrators discover when a patient is discharged from one facility and promptly readmitted to a different one. The data comes from admissions during the 12 months prior to March 31, 2007. It looks at 54 conditions and procedures for the 60,707 readmissions during that period. The readmissions were a subset of 877,228 total cases, according to the agency.

This move is particularly interesting given that state officials elsewhere have focused almost entirely on events that occur during a single hospitalization. It will be interesting to see whether other states track this type of data now that Florida has done so. Given that researchers and managed care organizations are quite interested in readmission rates, which can be a proxy for quality of care, doing so might be a good idea.

To learn more about Florida's efforts:
- read this Modern Healthcare article (reg. req.)

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Joint Commission delays medical-staff standard

Tue, 03 Jun 2008 06:59:55 -0400

The Joint Commission has decided to push back the date for hospitals to implement a new medical-staff standard, MS.1.20, pending further review. Hospital executives previously had expressed concern that as written, the standard would undermine their ability to engage in collaborative leadership. They also argued that the proposed model "tips the balance of power in favor of full medical staffs over their medical executive committees," according to a letter filed with the Commission by the Federation of American Hospitals. What's more, hospital leadership groups have argued that the standard would force some facilities with strong existing structures to revise them just to meet the Commission's requirements. Now, the Joint Commission's task force has agreed to spend more time conducting its review of the draft standard.

To learn more about the pending standard:
- read this Modern Healthcare piece

Consumers Union plans to rate hospitals

Thu, 29 May 2008 06:59:58 -0400

The venerable organization behind the popular Consumer Reports magazine has announced that it's getting into the hospital ratings act. The publisher, Consumers Union, already offers assessments of health-insurance plans, drugs and even some medical treatments, and is considering ratings of physician and elder groups. Its planned hospital ratings are the first step in a program to expand its healthcare ratings services.

Consumer Reports will rate about 3,000 facilities, and will include graphs showing ratings of care intensity and quality of care for nine serious conditions such as cancer and heart failure during the last two years of life. It also will include features reflecting average out-of-pocket costs for physician visits during the last two years of life for the nine conditions. The data will be drawn from the Dartmouth Atlas Project.

To learn more about the planned ratings:
- read this Wall Street Journal article (sub. req.)

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Study: Medicare quality perceptions similar despite spending

Wed, 28 May 2008 06:59:56 -0400

Despite regional variations in spending, Medicare beneficiaries perceived themselves as receiving a similar quality of care, according to a new study. Researchers looking at per capita Medicare spending and patient perceptions of care quality across 10 measures found no consistent correlation, according to results in an upcoming article to be published in the Journal of the American Medical Association.

In the study, Medicare regions were divided into five parts, with highest spending being $8,522 per capita and lowest being $5,209 per capita. Patients in regions with lower spending didn't think their needs for specialty providers or tests were unmet, researchers said. Meanwhile, while patients in higher-cost regions get more specialty care, see more doctors and spend more time in hospitals, they don't seem to survive longer or get more access to care.

To learn more about the study:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
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PA governor backs program for chronically ill

Mon, 19 May 2008 06:59:54 -0400

Pennsylvania Gov. Ed Rendell hopes to cut back on the amount of money spent on chronically ill patients while increasing the quality of care. In a speech to the Pennsylvania Homecare Association in Harrisburg, PA, Rendell described a new program aimed at doing just that. According to an article in the Philadelphia Inquirer, the program--one of the nation's most "comprehensive"--would "educate patients about ways to improve their health, coordinating their care through teams of primary care doctors and other health care professionals, and changing the way insurers reimburse health care providers for treatment." Rendell believes that more than treatments for chronic illnesses costing more than $4 billion could have been avoided last year had the proper steps been taken.

To learn more:
- read the Philadelphia Inquirer's article