Archive for the ‘Surveying The News’ Category

Penalizing Hospitals For Being Unsafe: Why Adverse Events Are A Big Problem

A Kaiser Health News article published Sunday about upcoming hospital penalties included an analysis of Medicare data by Dr. Ashish K. Jha, a professor at the Harvard School of Public Health. This week, Jha also wrote up his own take on the data. Originally posted on his Harvard blog, Dr. Jha’s copyrighted assessment is republished below, all rights reserved:

By Ashish K. Jha

Adverse events — when bad things happen to patients because of what we as medical professionals do — are a leading cause of suffering and death in the U.S. and globally.  Indeed, as I have written before, patient safety is a major issue in American healthcare, and one that has gotten far too little attention. Tens of thousands of Americans die needlessly because of preventable infections, medication errors, surgical mishaps, and so forth. As I wrote previously, according to Office of Inspector General (OIG), when an older American walks into a hospital, he or she has about a 1 in 4 chance of suffering some sort of injury during their stay.  Many of these are debilitating, life-threatening, or even fatal.  Things are not much better for younger Americans.

Given the magnitude of the problem, many of us have decried the surprising lack of attention and focus on this issue from policymakers.  Well, things are changing – and while some of that change is good, some of it worries me.  Congress, as part of the Affordable Care Act, required Centers for Medicare and Medicaid Services (CMS) to penalize hospitals that had high rates of “HACs” – Hospital Acquired Conditions.  CMS has done the best it can, putting together a combination of infections (as identified through clinical surveillance and reported to the CDC) and other complications (as identified through the Patient Safety Indicators, or PSIs).  PSIs are useful – they use algorithms to identify complications coded in the billing data that hospitals send to CMS.  However, there are three potential problems with PSIs:  hospitals vary in how hard they look for complications, they vary in how diligently they code complications, and finally, although PSIs are risk-adjusted, their risk-adjustment is not very good — and sicker patients generally have more complications.

So, HACs are imperfect — but the bottom line is, every metric is imperfect.  Are HACs particularly imperfect?  Are the problems with HACs worse than with other measures?  I think we have some reason to be concerned.


Wednesday, June 25th, 2014

Jon Stewart, Health Policy Wonk

Who knew comedian Jon Stewart was worried about essential health benefits? Health and Human Services Secretary Kathleen Sebelius found herself in the middle of a surprisingly substantive interview Monday night on Comedy Central’s “Daily Show” — 16 minutes of full-on wonkery, about half televised and half for the Web audience only.

The Daily Show With Jon StewartMon – Thurs 11p / 10c
Exclusive – Kathleen Sebelius Extended Interview Pt. 1
Daily Show Full EpisodesPolitical Humor & Satire BlogThe Daily Show on Facebook


Tuesday, January 24th, 2012

What Will States Do If Federal Dollars Stop Flowing?

With Congress continuing to struggle to reach a deal to raise the nation’s debt ceiling before the Aug. 2 deadline, speculation abounds about what might happen if the federal government goes into default. Many of the questions have to do with health care spending. The bottom line:  It’s a climate of uncertainty. Gail Wilensky, who ran Medicare and Medicaid during the George H.W. Bush administration told Politico last week,  “we’ve never been through anything like this” (Feder, 7/21).

With very little specific information to go on, news outlets report that state governments, in many respects, are bracing for the worst-case scenarios.


Friday, July 29th, 2011

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