HHS Sees $1 Billion Initiative Saving 60,000 Lives, Cutting Billions in Costs

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The Health and Human Services Department launched April 12 a $1 billion national patient safety initiative that aims to save 60,000 lives and reduce costs by $35 billion during the next three years.

The Partnership for Patients initiative will bring together stakeholders including hospitals, employers, consumer advocates, health insurers, and others to meet two primary goals by the end of 2013: reduce preventable hospital-acquired conditions by 40 percent and reduce preventable hospital readmissions by 20 percent, compared with 2010 levels.

To help meet those goals, HHS will invest $500 million in the Medicare Community-Based Care Transitions program, under which community organizations and hospitals will partner to help patients move safely from one care setting to another. In addition, the Center for Medicare and Medicaid Innovation will dedicate $500 million to help test models designed to curb hospital-acquired conditions and improve care transitions.

Funding for those efforts comes from the Patient Protection and Affordable Care Act.

HHS estimated three-year savings of $35 billion overall from the patient safety initiative, $10 billion of which would flow to Medicare. Over 10 years, the effort could result in Medicare savings of $50 billion and billions more in Medicaid savings, according to the department.

In addition, over the three-year period, the initiative would prevent 1.8 million injuries as well as 1.6 million hospital readmissions within 30 days of discharge, according to HHS.

Stakeholder Participation.

More than 500 hospitals, stakeholder groups, and businesses have pledged their support for the initiative and will identify specific steps they can take to improve patient care and safety. CMMI also will help hospitals implement care improvements through the development and dissemination of best practices.

The nation's major hospital organizations, including the American Hospital Association and the Federation of American Hospitals, have signed on to the partnership.

Centers for Medicare & Medicaid Services Administrator Donald M. Berwick said that the call for improvement is not intended to malign health care providers but to spur changes in a defective system. Doctors, nurses, and others are often the last line of resistance against even worse patient safety outcomes, Berwick said.

“Good people get trapped in bad systems,” he said at a briefing on the initiative.

More broadly, Berwick said, the push for improvement is central to the discussion of how best to ensure the quality and sustainability of the health care system.

“The options are two: either to cut care or to improve care,” he said. “I am against cutting; I am for improvement. And if you know the facts, improvement is the best way--it's the only right way--to get the care we want.”

Care Transitions Program.

The Medicare Community-Based Care Transitions program will accept proposals on a rolling basis, and funding will be awarded on an ongoing basis, according to a notice scheduled for publication in the April 15 Federal Register.

CMS is accepting proposals from qualified hospitals with high readmission rates that partner with community-based organizations that provide care transition services, the notice said.

“This program creates a source of funding for care transition services that effectively manage transitions from acute to community-based settings and report specified process and outcome measures on their results,” it said.

The community-based organizations will be paid on a “a per eligible discharge basis for eligible Medicare beneficiaries at high risk for readmission, including those with multiple chronic conditions, depression, or cognitive impairments,” the notice said.

The program will run for five years beginning April 11, and participants will be awarded two-year agreements that might be extended annually, the notice said.

CMS said applicants must identify the root causes of readmissions, define their target population, provide strategies for identifying high-risk patients, and specify strategies to improve care transitions.

Applicants also must “provide a budget including a per eligible discharge rate for care transition services, provide an implementation plan with milestones, and demonstrate prior experience with effectively managing care transition services and reducing readmissions.”

By Sarah Barr


More information about the partnership is at http://www.healthcare.gov/center/programs/partnership. The Federal Register notice is at http://op.bna.com/hl.nsf/r?Open=bbrk-8fur6h.