Adventist Health’s Post

😕 Challenges of grading hospitals on quality and safety of care 📊 https://lnkd.in/gc_Y4Mvm ➡ This Becker's news article caught my attention and confirmed what many of us in healthcare have observed for a long time. ➡ 15 hospitals in the last year were reported at risk of losing CMS funding due to an "immediate jeopardy" citation reflecting a critical lapse in quality and safety of care. Called "IJ" in the quality professionals's lingo, this is a hospital's worst nightmare. When a regulatory agency such as The Joint Commission, Centers for Medicare & Medicaid Services, or a state dept of public health arrives at a hospital for an inspection, we all worry about and hope that there is no IJ-level citation. Because IJ implies an immediate threat to the funding and operations of the hospital. ➡ However, 9 of these 15 hospitals receive a Leapfrog grade A to C, a fairly respectable safety grade. ➡ How is it possible to have a hospital be graded highly by one organization and extremely poorly by another? ➡ It is because none of the methodologies that measure and report a hospital's patient safety performance is accurate or adequate. And there are so many of them: Hospital Compare (https://lnkd.in/gG6MRE8g), CMS quality star rating (https://lnkd.in/gcR8p8B3), Leapfrog hospital safety grade (https://lnkd.in/gmHZiEDH), and the traditional but still popular US News & World report (https://lnkd.in/gRyYDhQX). And there are awards for quality such as Joint Commission Gold etc. ➡ Often, these report cards and grades are based on old data (from 6 months to 12, 24,36 months old), with varying methodologies, so the hospitals receive varying grades. ➡ The lesson here is that boards, the media, healthcare executives, patients, payors, and the public in general must recognize the flaws and limitations of all of these methodologies. And not give them more importance or weight than they deserve. ➡ I hope that in Patient Safety 3.0, we will have a nationally uniform, almost real-time, electronic/automated measurement of quality of safety that allows a valid and accurate reflection of a hospital's performance. And then patients and families can truly be said to have some power to make informed decisions and choices, at least for their elective non-emergent care. #ai #aihealthcare #patientsafety #qualitymanagement #performanceimprovement

This article from Modern Healthcare notes that Mass General Brigham sees hospital-at-home care as a big part of its long-term future. The Boston-based provider says it is on track to shift 10% of inpatient care to hospital-at-home within five years. Brigham and Women’s Hospital and Massachusetts General Hospital in Boston already offer hospital-at-home services for what amounts to 30 beds per day. The health system wants to increase that to 200 beds per day within a few years, starting with three Massachusetts hospitals: Newton Wellesley Hospital; Salem Hospital; and Brigham and Women’s Faulkner Hospital in Jamaica Plain. The article also states, however, that there are no guarantees CMS will continue to reimburse hospital-at-home services at parity with inpatient care. Shannon Germain Farraher, senior healthcare analyst at research and advisory company Forrester, mentions that scaling hospital-at-home to 10% of patient volume may be a way for hospitals to prove return on investment and to make the case for generous reimbursements. Read more: https://lnkd.in/gedqVzNd #advancedcareathome #hospitalathome

The Alliance for Rural Hospital Access is pleased to support the Assistance for Rural Community Hospitals (ARCH) Act (H.R. 6430), introduced by Representatives Carol Miller (R-WV) and Terri Sewell (D-AL). Hospitals located in rural areas face unique challenges in delivering high-quality, cost-efficient care to their communities. Patients in these areas are more likely to face chronic or life-threatening illnesses, and rural hospitals often serve as their primary source of care. At the same time, rural hospitals are increasingly strained by negative operating margins, often due to lower patient volumes and more complex conditions. H.R. 6430 recognizes these challenges and takes steps to better enable rural hospitals to overcome these obstacles. The legislation would extend the Medicare Dependent Hospital (MDH) program and the Low-Volume Hospital Payment Adjustment for five years, providing vulnerable hospitals with a period of predictable Medicare reimbursements and greater financial stability. In addition, H.R. 6430 would instruct the US Government Accountability Office to report and provide recommendations on rural hospital classifications, including the projected effects of updating Medicare reimbursement formulas Sole Community Hospitals (SCHs) and MDHs that are paid on the basis of their hospital-specific rate. This is a step in the right direction toward providing for a much-needed update to the current base years for SCHs and MDHs. “Representatives Miller and Sewell recognize the unique challenges that rural hospitals face, and they understand the need for Congress to pass legislation supporting these safety net providers,” said Eric Zimmerman, a representative for the Alliance for Rural Hospital Access. “We thank the Representatives for their efforts to safeguard the ability of rural hospitals to serve their patients and communities.” The Alliance encourages Congress to extend the MDH program and low-volume payment adjustment in advance of September 30, 2024—the current expiration date of the payment extensions. Read our letter of thanks to Reps. Miller (R-WV) and Sewell (D-AL): https://lnkd.in/gnUd9G9v #RuralHealth #RuralHealthcare

The momentum behind hospital-at-home programs is growing, with advocates emphasizing the need for Congress to take action to further support and invest in this model of care. Hospital-at-home initiatives gained traction during the COVID-19 pandemic, with programs like the Acute Hospital Care at Home Waiver by the Centers for Medicare and Medicaid Services (CMS) receiving significant attention and support. Proponents argue that these programs are viable, safe for patients, and deserve increased backing from policymakers to drive more investment and expansion. Efforts are underway to lobby Congress and CMS to sustain the progress made in hospital-at-home care, highlighting the benefits of this model in terms of patient safety, efficiency, and overall healthcare delivery. The push for legislative support underscores the potential of hospital-at-home programs to transform healthcare delivery by offering quality care outside traditional hospital settings, ultimately improving patient outcomes and experiences. #healthcare #hospitalathome https://lnkd.in/e8_yEsKv

Care is moving home... Eric Wicklund's insightful article in HealthLeaders discusses the growing support for making the "Hospital at Home" program a permanent fixture in healthcare. This innovative program, backed by a study from Mass General Brigham and funded by the National Institutes of Health, has shown promising outcomes: - Cost Savings: Pilots of the Hospital at Home model have achieved savings of more than 30% per admission compared to traditional hospital care. - Readmission Rates: The program has observed readmission rates between 7% and 10%, significantly lower than rates typically seen in conventional hospital settings. - Reduction in Care Costs: Brigham Health's randomized, controlled trial in 2020 showed that the adjusted mean cost for acute care episodes was reduced by 38% for patients in the Hospital at Home program. - Annual Financial Opportunities: Analysis identified approximately $4 million in annual opportunities for the average hospital by caring for eligible patients at home, highlighting significant financial benefits. https://lnkd.in/gbCgJ6iN #hospitalathome #valuebasedcare #jpm2024 #woundcare

The U.S. Department of Veterans Affairs announced that 67% of VA hospitals included in the Centers for Medicare & Medicaid Services (CMS) annual Overall Hospital Quality Star Ratings received either 4 or 5 stars, compared to only 41% of non-VA hospitals. This was the first time VA hospitals were included in the #CMS Star Ratings. The CMS uses 5 categories — mortality, safety of care, readmission, patient experience, and timely and effective care — to award a quality rating for each hospital. The more stars (out of 5), the better a hospital performed on the available quality measures. These findings are the latest in a series of recent evaluations showing the effectiveness of #VA health care compared to non-VA health care. VA hospitals outperformed non-VA hospitals on all 10 core patient satisfaction metrics in the recent Hospital Consumer Assessment of #Healthcare Providers and Systems Star Ratings, and a recent systematic review of more than 40 peer-reviewed studies found that VA health care is consistently as good as — or better than — non-VA health care. To read more, go to: https://lnkd.in/dsKgFs8z

Insightful comments on the future of HaH!

I appreciate the exploration of the pros and cons of #hospitalathome in this article. I look forward to more data in the future. If our nation is serious about this, we must shift the design of our housing stock through incentives and codes away from housing that dis-ables us as we age, to housing that enables us to maintain our physical independence as much as possible. Fortuitously, this also makes the provision of care in the home easier and more efficient. A cost benefit analysis would be informative. #ltss #homehealthcare #medicare #regionalhealth

The movement to decentralize care is about adding new pathways to better care for patients who require hospital-level care. During those moments when patients have limited control, when they need a hospital admission, the option to receive that care at home can be such a relief. Research is demonstrating that hospital care at home is safe and effective. https://lnkd.in/g6MkpNUp #hospitalathome

Steps forward