Safety-Net Hospitals Finding Ways To Offset Quality Penalties, AHRQ Study Suggests

AHRQ Stats: Decline in Hospitalizations

While the rate of hospitalizations (excluding pregnancies and newborns) declined for all age groups from 2000 to 2015, the biggest drop—25 percent—occurred among patients 65 and older. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #235: Trends in Hospital Inpatient Stays by Age and Payer, 2000-2015.)

Today's Headlines:

• Safety-Net Hospitals Finding Ways To Offset Quality Penalties, AHRQ Study Suggests.
• New AHRQ Views Blog Post: AHRQ’s EvidenceNOW Initiative—Reducing Primary Care Patients’ Risk of Heart Attacks.
• Grant Funding Available for Research on Diagnostic Safety in Ambulatory Care.
• Highlights From AHRQ’s Patient Safety Network.
• Medical Expenditure Panel Survey Revamps Tables for Household Data.
• Apply by Feb. 26 for AHRQ Summer Intramural Fellowship Program.
• AHRQ in the Professional Literature.

Safety-Net Hospitals Finding Ways To Offset Quality Penalties, AHRQ Study Suggests

Safety-net hospitals being penalized by Medicare value-based payment programs have found ways to offset those losses, but those methods may be volatile and temporary, an AHRQ study has found. Researchers examined the financial impacts of the Hospital Readmissions Reduction Program and the Value-Based Purchasing Program, which in 2013 began to financially penalize hospitals that failed to meet certain standards on hospital readmissions and other measures of quality. The analysis showed penalties were higher for safety net hospitals, which treat a large proportion of low-income patients. However, unlike other hospitals, safety-net hospitals appear to have offset higher penalties with revenues such as charitable contributions and government funding. Researchers cautioned that these funding streams may fail to compensate for losses over time. Access the abstract of the article, which was published in Health Services Research.

New AHRQ Views Blog Post: AHRQ’s EvidenceNOW Initiative—Reducing Primary Care Patients’ Risk of Heart Attacks

As AHRQ recognizes February as Heart Health Month, David Meyers, M.D., AHRQ's chief medical officer, shares stories from primary care practices in North Carolina, Oklahoma and Oregon that have made substantial improvements in their heart health care while receiving support from AHRQ's EvidenceNOW initiative. These practices expanded screening for high blood pressure, increased the use of smoking cessation counseling and provided enhanced care for patients identified at high risk for heart disease. Through EvidenceNOW, AHRQ is working with more than 1,500 small- and medium-size primary care practices to help improve the delivery of services proven to prevent heart attacks and strokes. These include the “ABCS” of heart health—Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. Dr. Meyers' blog post also describes how AHRQ's contributions to heart health are aligned with the Million Hearts® initiative, a national effort to combat heart disease, the nation's number one killer.

Grant Funding Available for Research on Diagnostic Safety in Ambulatory Care

Two funding opportunities from AHRQ have been extended to support research projects on understanding and improving diagnostic safety in ambulatory care. The announcement for R01 grants solicits project proposals to gain a better understanding of the complexity and incidence of diagnostic failures. The announcement for R18 grants seeks projects to evaluate strategies and interventions for reducing diagnostic failures and patient harms. Access a previous AHRQ Views blog post to learn more about agency activities in support of diagnostic safety.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Effect of an in-hospital multifaceted clinical pharmacist intervention on the risk of readmission: a randomized clinical trial.
• Trends in survival after in-hospital cardiac arrest during nights and weekends.
• To care is human—collectively confronting the clinician-burnout crisis.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Medical Expenditure Panel Survey Revamps Tables for Household Data

AHRQ has updated its Medical Expenditure Panel Survey (MEPS) online Household Component summary tables with easy-to-use drop-down menus for various types of data on health care use, spending, population demographics, insurance coverage, access to care, medical conditions and prescription drug purchases, among others. The summary tables can be viewed either by year or as a trend over time. They provide frequently used summary estimates for the U.S. civilian non-institutionalized population. Downloadable SAS and R codes are available for researchers seeking to replicate the tables from original MEPS files.

Apply by Feb. 26 for AHRQ Summer Intramural Fellowship Program

AHRQ has multiple openings for junior summer fellows, who will work with leading health services researchers while exploring “real life” issues that contribute to health care improvements. Applications are due by Feb. 26. Send questions to 2018SummerInternship@ahrq.hhs.gov.

AHRQ in the Professional Literature

Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey. Lee JS, Hu HM, Brummett CM, et al. JAMA 2017 May 16;317(19):2013-15. Access the abstract on PubMed®.

Receipt of caregiving and fall risk in US community-dwelling older adults. Hoffman GJ, Hays RD, Wallace SP, et al. Med Care 2017 Apr;55(4):371-8. Access the abstract on PubMed®.

Hospital characteristics associated with risk-standardized readmission rates. Horwitz LI, Bernheim SM, Ross JS, et al. Med Care 2017 May;55(5):528-34. Access the abstract on PubMed®.

Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant). Jayadevappa R, Chhatre S, Wong YN, et al. Medicine (Baltimore) 2017 May;96(18):e6790. Access the abstract on PubMed®.

High-value home health care for patients with heart failure: an opportunity to optimize transitions from hospital to home. Jones CD, Bowles KH, Richard A, et al. Circ Cardiovasc Qual Outcomes 2017 May;10(5). Access the abstract on PubMed®.

Environmental risk factors and their role in the management of atopic dermatitis. Kantor R, Silverberg JI. Expert Rev Clin Immunol 2017 Jan;13(1):15-26. Epub 2016 Jul 28. Access the abstract on PubMed®.

Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures. Kathuria P, Gordon KB, Silverberg JI. J Am Acad Dermatol 2017 Jun;76(6):1045-53.e3. Epub 2017 Mar 14. Access the abstract on PubMed®.

Variation in payment rates under Medicare's Inpatient Prospective Payment System. Krinsky S, Ryan AM, Mijanovich T, et al. Health Serv Res 2017 Apr;52(2):676-96. Epub 2016 Apr 8. Access the abstract on PubMed®.