What the Healthcare Law Ruling Means to You

President Obama signed the Patient Protection and Affordable Care Act (PPACA) in to law in March 2010 after a year of intense national debate. On Thursday last week, the U.S. Supreme Court upheld law, ruling that the individual mandate, which requires U.S. citizens and legal residents to have qualifying health coverage or pay a penalty, is constitutional as a tax. The ruling will have a far-reaching impact on healthcare providers, especially for those who work with underserved populations.

US Supreme Court

Grand Rounds: the Impact of Healthcare Reform

Welcome to Grand Rounds: the Impact of Healthcare Reform.

There’s a revolution occurring on the Web: those “authoritative” articles written on traditional, static websites are being replaced with blogs, wikis and online social networks. In the sphere of health, medicine and information technology, this “real-time Web” consists of many who are professionals in the field; their posts are listed below. In the digital age, these are the characteristics of new media: recent, relevant, reachable and reliable.

For this edition of Grand Rounds, Vol. 7 No. 11, we’re focusing on the impact of healthcare reform: what are the changes to healthcare delivery, utilization, quality, costs (either as a provider or a patient) and outcomes. After all, these changes affect everyone, whether you’re a patient, a healthcare provider or a biomedical researcher.

Healthcare reform

Consumer Hospital Comparison Website Now Includes Quality Data On Readmission Rates

Launched in 2002, the Hospital Quality Alliance (HQA) is a national public-private initiative that includes hospitals, physicians, nurses, federal agencies, quality experts, and consumer and business groups. HQA members collaborate to make meaningful, relevant and easy-to-understand information about hospital performance accessible to the public and to inform and encourage efforts to improve quality.

Last year, members of the HQA together with the Centers for Medicare & Medicaid Services and the Department of Health and Human Services created a consumer-oriented hospital comparison website called Hospital Compare. Hospital Compare provides information on how well hospitals care for patients with specific medical conditions or surgical procedures, as well as results from a survey of patients about the quality of care they received during a recent hospital stay.

hospital-quality-alliance

Yesterday, new quality data on hospital readmission rates was made available on the Hospital Compare website. The data includes hospital readmission rates for Medicare patients with heart attack, heart failure and pneumonia. This is especially relevant in today’s healthcare reform environment because the issue of hospital readmissions has been cited by policy makers and the Obama administration as a potential opportunity for improving healthcare quality and reducing unnecessary healthcare spending [2]. Indeed, a recent New England Journal of Medicine study found that almost one-fifth of Medicare beneficiaries discharged from the hospital were readmitted within 30 days; one-third were rehospitalized within 90 days [3].

Until now, hospitals have had only information on those patients who return to their own hospital, but not about patients who were readmitted to a different hospital. Using Medicare billing records from July 2005 to June 2008, the information on Hospital Compare shows how often a Medicare patient with one of these conditions returns to the same hospital or a different hospital within 30 days following their initial stay. Hospitals are placed in one of three categories based on their readmission rate in relation to a national readmission rate – “no different than the U.S. national rate”, “better than the U.S. national rate” or “worse than the U.S. national rate”. Each hospital’s readmission rate for the specific condition also can be compared to its state’s average. Additionally, each rate is shown as a single number, along with a confidence interval that indicates the range of certainty in which the hospital’s true performance falls.

The new quality data on hospital readmission rates is being added to existing information on how often hospitals take the right steps to provide care for their patients, as well as updated information on mortality rates. Available information includes statistics on a variety of quality measures such as:

  • Percent of surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection
  • Percent of surgery patients whose doctors ordered treatments to prevent blood clots after certain types of surgeries
  • Percent of heart attack patients given aspirin at arrival
  • Percent of pneumonia patients given the most appropriate initial antibiotic(s)
  • Percent of heart failure patients given discharge instructions
  • Percent of children who received reliever medication while hospitalized for asthma

In addition, Hospital Compare includes statistics on answers to a survey of patients’ hospital experiences, such as:

  • Percent of patients who reported that their doctors “Always” communicated well
  • Percent of patients who reported that staff “Always” explained about medicines before giving it to them.
  • Percent of patients at each hospital who reported that YES, they were given information about what to do during their recovery at home.

You can search for hospital information in your area using either a general search or a specific medical condition or surgical procedure search. The general search provides information on Hospital Process of Care Measures, Hospital Outcome of Care Measures, and Survey of Patients’ Hospital Experiences. The specific medical condition or surgical procedure search provides information on Hospital Process of Care Measures and Hospital Outcome of Care Measures (where applicable), Survey of Patients’ Hospital Experiences, and Medicare Payment and Volume. The Hospital Compare database is updated on a quarterly basis.

Interested in how your hospital stacks up to others in the area? Find and Compare Hospitals

References

  1. Vital New Quality Data on Hospital Readmission Rates Available on Hospital Compare Website. Hospital Quality Alliance press release. 2009 July 9.
  2. Health Reform’s Benefits for Middle Class Under Scrutiny. Kaiser Health News. 2009 Jun 25.
  3. Jencks et al. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418-28.
    View abstract

Grand Rounds 5.14 Holiday Edition

Seasons Greetings! Welcome to the Holiday Edition of Grand Rounds, featuring some of the best articles of the biomedical and healthcare blogosphere.

There’s a revolution occurring on the Web: those “authoritative” articles written on traditional, static websites are being replaced with blogs, wikis and online social networks. In the sphere of health, medicine and information technology, this “real-time Web” consists of many who are professionals in the field; their posts are listed below.
In the digital age, these are the characteristics of new media: recent, relevant, reachable and reliable.

At this time last year, I announced the Highlight HEALTH Network, a single source that aggregates content from all the Highlight HEALTH websites. This year, I have a similar gift for biomedical and healthcare blogosphere readers:

Health and Medicine blog carnival email and RSS subscriptions!