Hospital Participation in Value-Based Reforms Linked to Lower Readmission Rates
AHRQ Stats: Trends in Payments for Emergency Department Care
From 2006 to 2014, the number of emergency department (ED) visits covered by Medicaid increased by 66 percent while the number covered by Medicare rose by 29 percent. ED visits covered by private insurance, meanwhile, decreased by 10 percent. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #227: Trends in Emergency Department Visits, 2006-2014.)
- Hospital Participation in Value-Based Reforms Linked to Lower Readmission Rates.
- New AHRQ Views Blog Posts.
- Report Reviews Medication Strategies for Treating Opioid Use Disorder in Rural Settings.
- Highlights From AHRQ’s Patient Safety Network.
- High-Alert Medication Safety Self-Assessment Launched.
- New Training Program Helps Hospitals Prevent Pressure Ulcers.
- New Research and Evidence From AHRQ.
- AHRQ in the Professional Literature.
Readmission rates were lower among hospitals that took part in federal value-based reforms such as Meaningful Use, bundled payments for care and accountable care organizations (ACOs), according to an AHRQ-funded study. Using national data from Hospital Compare to examine hospital readmissions for about 2,800 hospitals from 2008 to 2015, researchers found that hospitals participating in all three programs reported the largest readmission declines. For example, hospitals that adopted all three programs compared with those that participated only in the Meaningful Use program reported larger drops in readmissions associated with heart attack (1.27 percentage points vs. 0.78), heart failure (1.64 vs. 0.97) and pneumonia (1.05 vs. 0.56). Hospitals that took part in these reforms in 2015 had nearly 2,400 fewer readmissions and saved Medicare more than $32 million, according to the study in JAMA Internal Medicine. Access the abstract.
Funding the Next Generation of Learning Health System Researchers: AHRQ and the Patient-Centered Outcomes Research Institute (PCORI) are partnering to award a total of up to $8 million annually to as many as 10 institutions to train researchers to work in learning health systems. Grantee institutions ill prepare clinician and research scientists for independent research careers within care delivery systems, equipping the scientists to advance the field through training and scholarship. A joint blog post by AHRQ Director Gopal Khanna, M.B.A., and PCORI Executive Director Joe Selby, M.D., M.P.H., further outlines the initiative. Funding applications are due January 24, 2018.
AHRQ’s Ongoing Support for the Fight Against Breast Cancer: A blog post by AHRQ Deputy Director Sharon Arnold, Ph.D., details how AHRQ fights breast cancer by providing data, funding research and supporting screening recommendations for women. October is Breast Cancer Awareness Month and AHRQ-funded statistical briefs highlight the rising number of double mastectomies and breast reconstruction surgeries. The agency has also supported evidence-based breast cancer screening recommendations and research on the effectiveness of DNA-based testing to determine treatment courses for breast cancer patients.
A new AHRQ report examines factors that may limit patients’ access to medication-assisted treatment (MAT) for opioid use disorder in rural primary care settings. MAT, in combination with counseling and behavioral therapies, is intended to support a “whole-patient” approach to treating substance use disorders. The report, Implementing Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care: Environmental Scan, explores the availability of tools to implement MAT as well as potential barriers to patient access, including stigma, logistical challenges, financing and policy concerns. Also included in the report are three models of care and nearly 250 tools and resources to help providers, patients and communities implement MAT in rural areas.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Defining and measuring diagnostic uncertainty in medicine: a systematic review.
- Patients' experiences with communication-and-resolution programs after medical injury.
- Evaluation of the association between Nursing Home Survey on Patient Safety culture measures and catheter-associated urinary tract infections: results of a national collaborative.
A new online patient safety tool is available to help hospitals, long-term care facilities and outpatient facilities evaluate their best practices related to high-alert medications, identify opportunities for improvement and track their experiences over time. Developed by the Institute for Safe Medication Practices (ISMP), the ISMP Medication Safety Self Assessment® for High-Alert Medications focuses on general high-alert medications and 11 specific medication categories including opioids, insulin, neuromuscular blocking agents, chemotherapy and moderate and minimal sedation. Participants who submit assessment findings to ISMP anonymously via a secure Internet portal can obtain weighted scores to compare with demographically similar organizations. Participation also can help organizations meet requirements for managing high-alert medications from regulatory and accrediting agencies, such as the Centers for Medicare & Medicaid Services and The Joint Commission. Access more information.
Hospital quality improvement (QI) staff, patient safety officers and others now have a new resource to help reduce the number of pressure ulcers, also known as pressure injuries, in hospitals. AHRQ’s Pressure Injury Prevention in Hospitals Training Program can help prevent pressure ulcers. Data provided by hospitals that implemented the program showed a decrease in the average number of pressure ulcers that was sustained for one year. The program is designed for those who want to launch an evidence-based, structured pressure injury prevention initiative based on QI principles. Access the training program and implementation guide.
The myth of standardized workflow in primary care. Holman GT, Beasley JW, Karsh BT, et al. J Am Med Inform Assoc 2016 Jan;23(1):29-37. Epub 2015 Sep 2. Access the abstract on PubMed®.
Management of diabetes mellitus in older people with comorbidities. Huang ES. BMJ 2016 Jun 15;353:i2200. Access the abstract on PubMed®.
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy. Ing C, Sun LS, Friend AF, et al. Reg Anesth Pain Med 2016 Jul-Aug;41(4):532-7. Access the abstract on PubMed®.
Inter-facility transfer of pediatric burn patients from U.S. emergency departments. Johnson SA, Shi J, Groner JI, et al. Burns 2016 Nov;42(7):1413-22. Epub 2016 Aug 20. Access the abstract on PubMed®.
Transitional care interventions and hospital readmissions in surgical populations: a systematic review. Jones CE, Hollis RH, Wahl TS, et al. Am J Surg 2016 Aug;212(2):327-35. Epub 2016 Jun 1. Access the abstract on PubMed®.
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation. Kaziunas E, Hanauer DA, Ackerman MS, et al. J Am Med Inform Assoc 2016 Jan;23(1):94-104. Epub 2015 Oct 28. Access the abstracton PubMed®.
Facilitative components of collaborative learning: a review of nine health research networks. Leroy L, Rittner JL, Johnson KE, et al. Healthc Policy 2017 Feb;12(3):19-33. Access the abstract on PubMed®.
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients. Liss DT, Brown T, Lee JY, et al. Cancer Causes Control 2016 Jul;27(7):881-7. Epub 2016 May 26. Access the abstract on PubMed®.
For comments or questions about AHRQ News Now, contact Bruce Seeman at Bruce.Seeman@ahrq.hhs.gov or (301) 427-1998.
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Page originally created October 2017