Cost Benchmark, Staffing Data, and more...

Hospitals, Health System Beat Cost Benchmark (by a Wide Margin)

Each year the state’s Health Policy Commission (HPC) sets a target for per-capita healthcare spending throughout Massachusetts and then tracks the components of the healthcare system to see if the state can meet the goal.  For 2017, the goal was 3.6% growth. Overall actual growth was 1.6% – or 2 full percentage points below the target, according to an HPC presentation last Thursday.

That 1.6% total healthcare spending growth rate in Massachusetts was well below the national rate (3.9%). 

Hospital outpatient spending grew 4.9% in 2017, down from a 5.6% growth rate the year before.  The other higher-than-benchmark category was pharmaceuticals, which had a 4.1% growth rate in 2017. The growth rate in hospital inpatient spending was just 1% in 2017, down from 2.8% the year before.  That is, the trend shows that spending for both inpatient and outpatient hospital care is dropping in the state. 

The HPC presentation also showed that commercially insured residents experienced a sharp increase in out-of-pocket spending between 2015 and 2017; the per-year cost of such spending was $1,733 in 2016 and rose 23% to $2,131 in 2017. (Out-of-pocket spending is defined as the amount of healthcare costs a person paid in the past 12 months that was not covered by any insurance or special assistance.)

The HPC found that after the formation of Beth Israel Lahey Health, the top five health systems will account for 70% of all commercial inpatient stays statewide. Those systems are Partners HealthCare, Beth Israel Lahey Health, UMass Memorial Health Care, South Shore Health, and Wellforce.

CHIA’s Newest Report is User-Friendly

The Health Policy Commission relies on the Center for Health Information and Analysis (CHIA) to gather the data it uses in many of its reports. CHIA’s latest report, released last week, provides information on acute and non-acute hospitals based on hospital characteristics, services, payer mix, utilization trends, cost trends, and financial performance over a five-year period through Fiscal Year 2017.  CHIA organized the data in a very user-friendly way, which allows the user to get hospital-specific data as well as information on the hospital sector as a whole. CHIA’s Massachusetts Hospital Profiles page is here.

AHRQ Offers Free Safety Program on Surgical Care and Recovery

The Agency for Healthcare Research and Quality (AHRQ), in coordination with the American College of Surgeons (ACS) and Johns Hopkins, is conducting a safety program for surgery and recovery.

Hospitals wishing to participate in the free program that begins in March 2019 can contact AHRQ’s Improving Surgical Care and Recovery (ISCR) team at iscr@facs.org.

Participating hospital teams – which AHRQ says must be multidisciplinary and can be led by surgeons, anesthesiologists, nurses and/or quality improvement professionals or hospital administrators – will have access to perioperative quality experts, and evidence-based clinical pathways ready for local adaptation. There will be tools, monthly coaching calls, in-person training, data collection platforms and more.

AHRQ says, “Participating hospitals can experience an improved uptake of multimodal analgesia and reduced opioid use, reductions in surgical site infections (SSI), reductions in catheter-associated urinary tract infections (CAUTI), reductions in venous thromboembolic events (VTE), improvement in patient experience, improvement in teamwork and safety culture, and improvement in length of stay and readmissions.”  More information is here.

Medical Errors Prevention Coalition Seeking Safety Presentations

The Massachusetts Coalition for the Prevention of Medical Errors is seeking proposals for presentation at its April 3, 2019, Patient Safety Forum at the Sheraton Framingham. 
The Coalition is particularly interested in presentations related to:  
Transformational strategies that accelerate improvements in safety and that build improvement into daily processes, including:
Leadership approaches
Improvement and safety culture (including reducing staff burnout/enhancing joy in work; and building teamwork and communication)
Organizational learning systems and process improvement (daily safety huddles, unit-based improvement, coaching/training) 
Patient and family engagement
Staff engagement 
Strategies for improvements in reducing diagnostic errors; care transitions/handoffs; health information technology; and settings other than inpatient.
If you are interested in presenting your work during the 2019 Patient Safety Forum, please prepare a summary using this form and e-mail it to the Coalition’s Amelia DeFelice at adefelice@macoalition.org by January 7th. (If you are planning on submitting a proposal, please let Amelia know as soon as possible, and include the topic, to assist the Coalition in its planning.)

Staffing Data for Every Hospital Unit is Easily Available

The PatientCareLink website now contains the budgeted staffing plans for nearly every unit of each hospital in Massachusetts for FY 2019.  Web visitors can select specific hospitals and see the staffing plans for more than 700 individual units, including emergency departments, at 80-plus acute care and post-acute hospitals across the state. The budgeted plans also show descriptions of the type of care provided on the various units, team members who support patient care, and any changes in the types of patient care units from year to year.

Through PatientCareLink, hospitals also file their actual staffing plans from the previous year and explain what actions were taken if there is a significant variation (+/-5%) from the budgeted plan. The actual staffing and variance from budgeted data is expected to be posted in the spring of 2019. Massachusetts hospitals have voluntarily posted this staffing information for 13 years.

Patient outcomes such as fall rates, pressure ulcer rates, and Hospital Compare measures are also listed here on PatientCareLink.

2019 Joint Commission Update

Friday, January 18, 2019; 8:30 a.m. - 2:30 p.m.
Conference Center at Waltham Woods, Waltham, Mass.

Hospitals need to stay abreast of the evolving compliance issues and shifting priorities regarding Joint Commission accreditation. At this year’s conference, we’re bringing back popular speaker Mark Crafton, executive director for state and external affairs at The Joint Commission. Mark is the expert on Joint Commission standards and he’ll provide an update on the challenging standards from 2018 and highlight some of the new standards for 2019. We will also feature a hot-topics session from David Szabo, Esq., co-chair of the healthcare practice at Locke Lord LLP, and conclude with a panel of your colleagues from recently surveyed hospitals with the goal of sharing tips and updates about current priorities.  Visit here for a list of speakers and registration information.

John LoDico, Editor