Medicare Pay-for-Performance Programs Not Linked to Consistent Quality, Safety Improvements

AHRQ Stats: Average Employee Insurance Contributions

Overall, the average employee contribution for single coverage increased by 7.2 percent to $1,643 between 2020 and 2021, while single premium contributions increased by 12.3 percent, 14.1 percent and 5.6 percent at small, medium and large firms, respectively (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #543, Trends in Health Insurance at Private Employers, 2008-2021.)

Today's Headlines:

• Medicare Pay-for-Performance Programs Not Linked to Consistent Quality, Safety Improvements.
• Register Now for September Webinars About Joining AHRQ’s MRSA Prevention Program.
• Organizational Capabilities Predict Use of Patient-Reported Outcome Measures.
• AHRQ Accepting Proposals To Establish Patient Safety Learning Laboratories .
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Medicare Pay-for-Performance Programs Not Linked to Consistent Quality, Safety Improvements

Medicare’s three hospital pay-for-performance (P4P) programs are not associated with consistent improvement in quality or patient safety measures, an AHRQ-funded study in BMC Health Services Research concluded. Researchers used 2007–2016 data from AHRQ’s Healthcare Cost and Utilization Project for 14 states to identify hospital-level inpatient quality and patient safety indicators. They also found that mortality rates generally got worse over the study period. Medicare assessed $956 million in penalties in 2019 to hospitals that failed to meet benchmarks or show improvement under the Hospital Readmission Reduction Program, the Hospital-Acquired Conditions Program and the Hospital Value-Based Purchasing Program. Given the evidence of limited impact, the cost of monitoring and enforcing penalties, and potential increase in mortality, researchers concluded that the Centers for Medicare & Medicaid Services should redesign its P4P programs before continuing to expand them. Access the abstract.

Register Now for September Webinars About Joining AHRQ’s MRSA Prevention Program

AHRQ’s Safety Program for MRSA Prevention is recruiting hospital surgical teams seeking to reduce infections for high-risk surgeries, such as open heart, hip/knee replacement and spinal fusion. Surgical site infections (SSIs) are one of the most common and costly healthcare-associated infections, and SSIs due to MRSA (methicillin-resistant Staphylococcus aureus) can be more harmful and costly than SSIs due to other organisms. AHRQ’s free 18-month program begins in January and will provide expert coaching, online training, tools and resources to protect patients and strengthen patient safety efforts to prevent SSIs, especially those due to MRSA. Learn more about the program and how to register for one of four live informational webinars in September. Additional webinars are scheduled in October.

Organizational Capabilities Predict Use of Patient-Reported Outcome Measures

Health systems and physician practices with strong capabilities in chronic care management, medical and social risk screening, and support for patient responsiveness were more likely to adopt patient-reported outcome measures for depression, pain and disability, according to an AHRQ-funded study in the Journal of General Internal Medicine. Researchers analyzed survey data from 323 U.S. health systems and 2,190 physician practice respondents to assess capabilities associated with adoption of measures for three medical conditions: diabetes, heart failure and musculoskeletal issues. The authors concluded that developing the relevant practice-level capabilities may improve adoption of these measures more than solely expanding health information technology functions. Access the abstract.

AHRQ Accepting Proposals To Establish Patient Safety Learning Laboratories

AHRQ is accepting proposals from multidisciplinary research teams to establish Patient Safety Learning Labs that use a systems engineering approach to develop, implement and evaluate innovative solutions to patient safety problems. Applicants may focus on current pressing patient safety issues such as: patient falls, medication safety, provider burnout, resiliency of healthcare systems in the wake of a crisis and more. Proposal due dates are Sept. 25 and Jan. 25, 2023, depending on funding cycle. Access the funding announcement for information on how to apply, plus background on previously funded Patient Safety Learning Labs.

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:

• Accuracy of pressure ulcer events in US nursing home ratings.
• Emergency department adverse events detected using the emergency department trigger tool.
• Teamwork before and during COVID-19: the good, the same, and the ugly…

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).

AHRQ in the Professional Literature

Implementation and effectiveness of integrating palliative care into ambulatory care of noncancer serious chronic illness: mixed methods review and meta-analysis. Chyr LC, DeGroot L, Waldfogel JM, et al. Ann Fam Med 2022 Jan-Feb;20(1):77-83. Access the abstract on PubMed®.

Is bigger better?: A closer look at small health systems in the United states. Sherry TB, Damberg CL, DeYoreo M, et al. Med Care 2022 Jul;60(7):504-11. Epub 2022 Apr 28. Access the abstract on PubMed®.

"Beyond just a supplement": administrators' visions for the future of virtual primary care services. Fraze TK, Beidler LB, De Marchis EH, et al. J Am Board Fam Med 2022 May-Jun;35(3):527-36. Access the abstract on PubMed®.

Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections. Wurcel AG, Essien UR, Ortiz C, et al. JAMA Netw Open 2021 Dec;4(12):e2140798. Access the abstract on PubMed®.

Improving the specificity of drug-drug interaction alerts: can it be done? Reese T, Wright A, Liu S, et al. Am J Health Syst Pharm 2022 Jun 23;79(13):1086-95. Access the abstract on PubMed®.

Effect of Stanford Youth Diabetes Coaches' Program on youth and adults in diverse communities. Patil SJ, Tallon E, Wang Y, et al. Fam Community Health 2022 Jul-Sep;45(3):178-86. Epub 2022 Apr 5. Access the abstract on PubMed®.

Associations of Medicaid expansion with insurance coverage, stage at diagnosis, and treatment among patients with genitourinary malignant neoplasms. Michel KF, Spaulding A, Jemal A, et al. JAMA Netw Open 2021 May 3;4(5):e217051. Access the abstract on PubMed®.

Machine learning-assisted screening for cognitive impairment in the emergency department. Yadgir SR, Engstrom C, Jacobsohn GC, et al. J Am Geriatr Soc 2022 Mar;70(3):831-7. Epub 2021 Oct 13. Access the abstract on PubMed®.