Healthcare Costs Reduced by Collaboration, 24,820 Deaths Prevented at
157 Hospitals in National Initiative's First Three Years
In three years, 157 hospitals participating in the Premier healthcare alliance's QUEST®: High Performing Hospitals national collaborative have saved an estimated 24,820 lives and reduced healthcare spending by nearly $4.5 billion. QUEST can be adopted by any hospital in the nation seeking to track performance against a higher standard of care. If all hospitals in the country had been able to achieve similar results, estimates project an additional 87,250 lives and $34 billion more could be saved across all payors each year. These are savings that hospitals can use to reinvest in care improvements for their local communities.
Spanning 31 states, QUEST includes a nationwide sample of urban/rural, large/small, teaching/non-teaching and safety net hospitals. Together the hospitals volunteered to transparently share data and define a common framework with consistent measures of top performance – something that has never existed in healthcare. During QUEST's first three years, hospitals tracked and compared their performance levels to match or exceed the top 25 percent of hospitals in all categories except cost, which was set at the top 50 percent. To reach these standards, hospitals needed to:
"QUEST creates new, higher targets that any hospital can strive for," said Terry Andrus, CEO of East Alabama Medical Center. "Once we saw what could be achieved, we had a very systematic way to focus and work on performance improvement. All the QUEST measures are very clear, making it easier for us to articulate the vision of where we want to be, and get buy-in from doctors, nurses, administrators and our board. It's crystallized our quality work and given us a clear path forward."
East Alabama Medical Center and 120 other hospitals participating in QUEST achieved top performance standards that directly led to patient care improvements and other quality gains. These advances have historically eluded most healthcare improvement programs. In fact, QUEST hospitals are far outpacing current industry trends and national averages.
For example:
When compared to a national group with similar characteristics, the mortality rate among QUEST hospitals was 29 percent lower than national averages, according to Medicare data from federal fiscal year 2009, the most recent year of this information.
Data from the U.S. Bureau of Labor and Statistics suggests that QUEST hospital inpatient costs only increased by about 2 percent above the rate of inflation over three years (2008-2010). In contrast, non-participant costs increased by an average of 17 percent above inflation.
"QUEST gave us the ability to look at ourselves differently,” said Donna Isgett, senior vice president of corporate quality and safety, McLeod Health. "When we just looked at our data we thought we were doing well, but when we compared to others we realized we weren't among the best. For mortality, we talked to other top performers to learn how they tested, analyzed and measured their data to come up with better processes. We did something similar and have been able to replicate those high performance scores to save lives at McLeod. Now we are sharing our own learnings and best practices with others."
QUEST hospitals have been measuring 24 specific harm events that align closely with national priorities, including the Medicare value-based purchasing program, the Centers for Medicare & Medicaid Services non-payment policy, and the Partnership for Patients hospital quality improvement and safety initiative. However, while many organizations have targeted hospital-acquired conditions (HACs) based on these and other federal policies, QUEST data shows that a broader focus on harm may be required. As a result, QUEST is now examining more than 140 HACs that have been shown to cause deaths, added length of stay and unnecessary costs. These new measures will be rolled into the program over time.
Susan DeVore, Premier president and CEO said, "QUEST hospitals show what's truly possible in healthcare. Together they have proven that top performance can be achieved by any hospital, no matter where they are, what their patient mix or their reimbursement levels. QUEST is discovering the keys to providing the best quality care and teaching others how to replicate their accomplishments so that we don't have pockets of excellence – we have system-wide excellence."
Most recently, QUEST hospitals have been driving improvement in patient experience and are already ahead of national averages. In fact, according to data from Medicare's Hospital Compare database, QUEST hospitals have improved patient experience levels by 4.9 percent, as opposed to non-participants, whose scores improved by just 2.6 percent.
Participants also expanded their focus on reducing readmissions to better understand and make evidence-based recommendations to CMS on how to appropriately implement new readmission policies. Additionally, the collaborative is adding new evidence-based care measures across the inpatient and outpatient settings.
"Hospitals participating in QUEST have demonstrated that putting patients first makes good business sense. By scaling this comprehensive improvement model with data-driven approaches, they set the standard for new care delivery models," said Tanya Alteras, associate director of the Consumer-Purchaser Disclosure Project at the National Partnership for Women & Families. "QUEST addresses the larger picture of patient safety, costs and efficiency in healthcare organizations. The fact that QUEST has been designed to align with federal and other private sector delivery system models, such as bundled payments and accountable care, is a crucial building block to creating patient-centered, coordinated care systems that drive us toward better care at lower cost."
Premier reviewed year 3 QUEST results with academic researchers from the Center for Quality of Care Research at Baystate Health to ensure they were accurate, and not anomalies due to measurement or analytic approaches. Reviewers also provided feedback on how to better collect and use data moving forward to help draw causal pathways from improvement strategies to the outcomes seen in Premier measures.
About the Premier healthcare alliance, Malcolm Baldrige National Quality Award recipient
Premier is a performance improvement alliance of more than 2,500 U.S. hospitals and 80,000-plus other healthcare sites using the power of collaboration to lead the transformation to high quality, cost-effective care. Owned by hospitals, health systems and other providers, Premier maintains the nation's most comprehensive repository of clinical, financial and outcomes information and operates a leading healthcare purchasing network. A world leader in helping deliver measurable improvements in care, Premier has worked with the Centers for Medicare & Medicaid Services and the United Kingdom's National Health Service North West to improve hospital performance. Headquartered in Charlotte, N.C., Premier also has an office in Washington. http://www.premierinc.com.
ABH CONSORTIA NEWS - Week of January 23, 2012
Economic Downturn Leads To
One Billion Worth of Angst
Anti-depressant and anxiety drug use has risen 26 per and cost the health service over one billion since the start of the economic downturn in 2007, according to research issued December 2011. A study by The Cooperative Pharmacy into antidepressant and anxiety drug dispensing across over 150 primary care facilities in England found that in 2010-2011 49.8 million items were prescribed, up from 39.5 million items in 2007-2008.
However, costs have fallen – down 12 percent from almost 291 million in 2007-2008 to 258 million in 2010-2011. In 2010-2011, the North West had the highest usage of anti-depressants and anxiety medication, with over 8 million items prescribed. It was followed by East of England (5.7m) and Yorkshire and Humber (5.45m)
The biggest increase in use over the last four years has been in the East Midlands up 44 percent from 3 to 4.4 million items followed by the North East, up 29 percent from 2.7 to 3.5 million items. Findings by The Cooperative Pharmacy revealed that between 2007-2008 and 2010-2011 the NHS has spent 1.071 billion on prescribed anti-depressants and anxiety drugs. It has also funded a further 1.073 billon on drugs for treating psychoses and other related disorders.
Mandeep Mudhar, NHS Business Director, The Cooperative Pharmacy, said: “Our research has shown that the NHS is getting greater value for money but worryingly prescription items have risen at an alarming rate, up 26 per cent in just four years.
“It is clear more people are seeking medical help to treat depression and anxiety. However, there are many more people who do not share their experiences. If people do feel depressed we urge them to seek medical help.”
The research found that citalopram hydrobromide was the most common anti-depressant medication (12.1 million items prescribed in 2010-2011) followed by amitriptyline HCl (8.8 million prescription items). 5.2 million items of fluoxetine (known commonly as Prozac) were prescribed in 2010-2011. Diazepam was the most widely prescribed drug for anxiety (1.5 million items prescribed in 2010-2011).
Emer O’Neill, Chief Executive of Depression Alliance, said: “For some people depression just happens, but for others it is triggered by stressful events, for example losing a job, property or bereavement. These uncertain economic times are linked to an increase in the number of people with the illness.
“However, this is just the tip of the iceberg, as for every person diagnosed with depression there are many more who suffer in silence. Getting an early diagnosis, finding the right support mechanisms and treatment for each individual is crucial to beating the illness.
At this time of year, many individuals can feel lonely or isolated but there are a range of support groups available to help with depression. Talking about your feelings is the first step to getting help whether it’s making them known to a friend or family member. It is also important to speak to a healthcare professional such as your GP or pharmacist who can help you to find the best way forward.”
ABH CONSORTIA NEWS - Week of January 16, 2012
Rehabmart.com Collaborates with Bionix Medical Technologies to
Offer Innovative Medical Supplies to Healthcare Professionals
Rehabmart.com, an online e-commerce company that sells rehabilitation and medical supplies, has formed a collaboration with Bionix Medical Technologies, a division of Bionix Development Corporation, to offer their innovative medical supplies to licensed medical professionals. For over a quarter of a century, Bionix Development Corporation has been a world leader in the development, manufacturing and marketing of cutting-edge medical devices and equipment.
Rehabmart.com, an online e-commerce company that sells rehabilitation and medical supplies, has formed a collaboration with Bionix Medical Technologies, a division of Bionix Development Corporation, to offer their innovative medical supplies to licensed medical professionals. For over a quarter of a century, Bionix Development Corporation has been a world leader in the development, manufacturing and marketing of cutting-edge medical devices and equipment. Bionix places their focus on helping physicians and other healthcare professionals to meet the high pressure demands of a modern healthcare environment that continues to change rapidly.
Founded in 1984 by Dr. Andrew J. Milligan, Ph.D. and Dr. James Huttner, M.D., Ph.D., Bionix was created from the friendship these two doctors forged when they met at the Medical College of Ohio (now called the University of Toledo Medical Center). Dr. Milligan was teaching Radiation Therapy and Dr. Huttner, who was completing his pediatric residency at the time, took a rotation in that department. The two doctors quickly became friends and together they formed a couple of unique medical product ideas.
Dr. Huttner had an idea for a single-use ear curette created from a flexible plastic that would be safer to use on his pediatric patients. Dr. Milligan had an idea for an intra-operative radiation therapy applicator. With these two initial product ideas, they formed the two principle divisions of Bionix Development Corporation; Medical Technologies and Radiation Therapy. Bionix has continued to invent innovative products ever since, expanding the product lines for both divisions. Bionix Medical Technologies has become the ‘gold standard’ for cerumen (ear wax) removal technology, while their Radiation Therapy division is a leading patient positioning and immobilization provider. Bionix Development has expanded to serve other areas of healthcare as well with National Safety Technologies and Prosthetic Solutions divisions.
“We are proud to offer these state-of-the-art products from Bionix Medical Technologies to our healthcare professional customers.” said Hulet Smith, Founder and CEO of Rehabmart. “The positive testimonials abound from physicians and healthcare providers who have used their various ear curettes, ear-wax removal systems, disposable plastic speculums, various forceps and their other many innovative products, and we are very pleased to introduce these helpful products to more medical professionals.
ABH CONSORTIA NEWS - Week of January 09, 2012
Dartmouth Creates Fourteen-School
Alcohol Use Collaborative
Dartmouth collaborated with fourteen other colleges and universities on a new initiative — the Learning Collaborative on High-Risk Drinking — to address alcohol use on campuses across the country. The Collaborative uses information exchanges to determine effective ways to combat alcohol abuse.
The Collaborative is a product of a partnership between the College and The Dartmouth Institute for Health Policy and Clinical Practice. Each school appointed a team consisting of students, administrators and faculty members to participate in a monthly conference call to discuss various approaches to alcohol policy implemented on member campuses, College President Jim Yong Kim said in an interview with The Dartmouth Editorial Board. The teams meet in person every six months.
Boston University, Cornell University, Duke University, Northwestern University, Ohio University, Princeton University, Purdue University, Stanford University, Wesleyan University, the University of Wyoming, Stony Brook University, Frostburg State University and Sewanee: The University of the South also joined the Collaborative. The Collaborative will host three learning sessions in June 2011, January 2012 and July 2012, and will publish its findings at the conclusion of the meetings.
ABH CONSORTIA NEWS - Week of January 02, 2012
Aetna and Intercoastal Medical Group Provider Collaboration
Model Leads to Fewer Hospitalizations for Certain Patients
As groups throughout the health care system work to develop Accountable Care Organizations (ACOs), Aetna announced results of a collaborative relationship with Intercoastal Medical Group (Intercoastal), a multi-specialty medical group based in Sarasota, Florida. Since 2009, Aetna and Intercoastal have worked together to accomplish two of the main goals of ACOs through the Aetna Medicare Provider Collaboration program – improving quality of care and lowering health care costs.
Intercoastal provides care to more than 500 Aetna Medicare Advantage members through Aetna’s Provider Collaboration program. To date, more than 97 percent of these Aetna Medicare Advantage members visited their health care provider in 2011 to receive preventive and follow-up care. Compared with Medicare beneficiaries residing in the state of Florida who are enrolled in Original Medicare, this Aetna Medicare Advantage population experienced 37 percent fewer inpatient hospital days on a risk-adjusted basis and 27 percent fewer hospital readmissions.
“By working more effectively and efficiently with outstanding health care providers like Intercoastal, we have demonstrated that we can help improve the coordination and quality of care and reduce health care costs,” said Randall Krakauer, MD, FACP, FACR, Aetna’s national Medicare medical director. “Aetna believes patient-centered collaboratives can serve as one stepping stone to the creation of Accountable Care Organizations which further align financial incentives with high quality, more efficient care. We will continue to improve our Provider Collaboration program and expand the program to other health care providers across the country that deliver services to Aetna’s Medicare Advantage members.”
Coordinated Care Helps Improve Health Outcomes
One of the major components of the collaborative relationship with Intercoastal is the Aetna nurse case manager who helps coordinate care for Aetna Medicare Advantage members. As part of the Provider Collaboration program, the Aetna nurse case manager is dedicated specifically to working with the clinical staff and Aetna Medicare Advantage members receiving treatment from Intercoastal physicians.
The Commonwealth Fund described Aetna’s work with a similar “embedded” nurse case manager model in a recent case study (Sept. 2010). Aetna's data on the model suggests that the model has decreased duplicate or unnecessary services and improved health outcomes. For example, compared to unmanaged Medicare, Aetna Medicare Advantage members required 43 percent less acute (critical) hospital care in 2010.
Aetna nurse case managers also use advanced technology to monitor the care and health progress of Aetna Medicare Advantage members. The technology is supported by the ActiveHealth CareEngine® System. The CareEngine continuously monitors all available information on patients, compares it to current medical evidence, and identifies and alerts the member and doctors to possible urgent situations and opportunities to improve the patient’s care.
Through the Provider Collaboration program, Intercoastal has met a number of clinical quality metrics agreed upon by both sides, including: Increasing the percentage of Aetna Medicare Advantage members who have an office visit each calendar year; Encouraging office visits every six months for members with chronic heart failure (CHF) or diabetes; Encouraging HbA1C (blood glucose) tests each calendar year for members with diabetes; and Confirming that members schedule follow-up visits within 30 days of being discharged from an inpatient stay.
Aetna provides Intercoastal with reports showing quality and efficiency measures at the individual member and population level. “We have always appreciated the support we received from Aetna nurse case managers, but having somebody who is focused specifically on the Aetna Medicare patients in our practice certainly helps improve the connection between the nurse case manager and our clinical staff,” said John M. Steele, MD, President of Intercoastal Medical Group. “With this program, we can help ensure that our patients are receiving the right care at the right time.”
Aetna is working with a number of health care organizations to develop products and services that support value-driven, patient-centered care. The Aetna models and capabilities are described on the company’s new accountable care website at www.aetnaacs.com.
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| ABH CONSORTIA NEWS - Week of January 30, 2012 | ||||
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