The OIG Aftermath

Policy Points

Patient Safety Toolkits Available from AHRQ

The Agency for Healthcare Quality and Research (AHRQ) has released 17 toolkits for Partnerships in Implementing Patient Safety (PIPS). The toolkits were developed by AHRQ-funded experts, including several hospitalists who specialize in patient safety research. They’re designed to help physicians, nurses, hospital managers, patients, and others reduce medical errors. For details to access the toolkits, visit AHRQ’s Web site at www.ahrq.gov/qual/pips.

Money Tops List of Hospital CEOs’ Worries

It’s no surprise that, according to a 2007 survey by the American College of Healthcare Executives (ACHE), financial challenges again ranked as the top concern for hospital chief executive officers. In its annual survey of top issues confronting hospital CEOs, ACHE asked respondents to rank the three most pressing issues affecting their hospital and identify specific areas of concern. Seventy percent cited financial challenges as one of their top three concerns, compared with 72% in 2006 and 67% in 2005. Providing care to uninsured patients placed second, followed by hospital relationships with physicians, according to the survey results.

Congress Boosts Budget for AHRQ

At the end of its 2007 term, Congress approved an omnibus bill that provides fiscal year 2008 funding for many federal health agencies, including AHRQ. The bill boosts AHRQ’s funding from $319 million to $334 million, including $30 million earmarked for comparative effectiveness research.

CMS Offers Education on Two Hot Topics

A new program from the Centers for Medicare and Medicaid Services (CMS) concerning hospital-acquired infections is expected to have a significant effect on hospital medicine.

Secretary of Health and Human Services Mike Leavitt was charged with identifying at least two conditions that:

• Are high cost, high volume, or both;
• Result in the assignment of a case to a diagnosis-related group that has a higher payment when present as a secondary diagnosis; and
• Could reasonably have been prevented through the application of evidence-based guidelines.

After September, hospitals will not receive additional payment for discharges when one of the conditions is acquired during hospitalization.

Two fact sheets are available on the CMS Web site (www.cms.hhs.gov/ HospitalAcqCond):

• “The Hospital-Acquired Conditions (HAC) in Acute Inpatient Prospective Payment System (IPPS) Hospitals Fact Sheet”; and
• “The Present on Admission (POA) Indicator Reporting by Acute Inpatient Prospective Payment System (IPPS) Hospitals Fact Sheet.”

Also available are those conditions being considered for fiscal year 2009 rulemaking process and reporting requirements.

Hospitalists’ consistent and complete medical documentation will become even more important under this program. Medical record documentation from any provider involved in the care and treatment of the patient can be used to support the determination of whether a condition was present on admission.—JJ