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Hospital-acquired conditions plummet, CMS says, touting new payment models

From 2010 to 2014, there's been 2.1 million fewer hospital-acquired conditions and $19.8 billion in costs have been averted.

Susan Morse, Senior Editor

The Centers for Medicare and Medicaid Services on Tuesday said fewer patients are being affected by hospital-acquired conditions, saving of billions of dollars and offering proof that new models of care are working.

From 2010 to 2014, there's been 2.1 million fewer hospital-acquired conditions; 87,000 fewer hospital-acquired condition related deaths; and $19.8 billion in costs have been averted, according to CMS Deputy Director Patrick Conway.

This data shows a 17 percent decline in hospital-acquired conditions from 2010 to 2014, from 145 to 121 per 1,000 discharges.

Approximately 2.1 million fewer incidents of harm occurred from 2011 and 2014, compared with 2010, according to the Department of Health and Human Services. About 40 percent of this reduction is from adverse drug events; about 28 percent from pressure ulcers; and about 16 percent from catheter-associated urinary tract infections. 

Interim 2014 estimates indicate that more than 36,000 fewer patients died in hospitals in 2014 as a result of the decline in hospital-acquired conditions, compared with the number of deaths that would have occurred if the rate had remained steady at the 2010 level, according to HHS. Most of the deaths averted occurred as a result of reductions in the rates of pressure ulcers and adverse drug events.

While the reasons for this progress are not fully understood, the agency said, likely contributing causes include financial incentives created by CMS and other payers' payment policies; public reporting of hospital-level results; technical assistance offered to hospitals; and the widespread implementation of electronic health records. 

Conway called data showing mortality rates of 300,000 fewer deaths between 1999 and 2013, "jaw dropping."

[Also: Hospitals score $110 million from CMS to reduce medical errors, hospital-acquired conditions]

Changes in healthcare delivery have resulted in three million beneficiaries staying home and healthy rather than being hospitalized each year, Conway said.

Conway announced the figures Tuesday during a CMS Quality Conference in Baltimore.

Payment models are changing from reimbursement for fee-for-service to one which rewards quality and value. As recently as 2011, zero percent of reimbursement was tied to alternative payment models, Conway said.

CMS has pledged to have 30 percent of Medicare payments tied to value by 2016; and 50 percent by 2018.

[Also: Hospital-acquired infection measures flawed; top-tier hospitals see most fines]

"I'm confident we're on target to meet that 2016 goal," Conway said.

When Maryland moved to a population based payment model, with more than 90 percent of its revenue from population-based payments, it realized more than $100 million in savings the first year, he said.

"There's been more improvement in the health system during the last five years than I've ever seen before," Conway said.

Health systems have often struggled to keep up with targets that financially reward CMS goals of quality measures.

Twitter: @SusanJMorse