HAI’s and Carechex

Those of us lucky enough to live to a ripe old age will almost certainly need a surgical procedure at one time or another.  We have a pain or other issue, we go to the doctor.  Sometimes we decide, with the help of a physician, that surgery is the answer.  We choose a surgeon, make arrangements with our employer and family, maybe even plan what we’ll do when it’s all over.  And when the procedure is routine, we feel confident.  Hospitals can be scary, but we’ll be just fine.

Won’t we?

 

The Centers for Disease Control estimate that 2011 saw 721,800 hospital-acquired infections (HAIs).  Worse yet, approximately 75,000 patients, or more than 10 percent, died during their hospital stay.  Hospitals can be incredibly dangerous.

The good news?  First, HAI rates are on the decline.  The CDC’s 2014 progress report, which comprised HAI data collected from over 14,500 healthcare facilities nationwide, showed some promising statistics:

  • Between 2008 and 2013, central line-associated bloodstream infections dropped by 46 percent.
  • Between 2008 and 2013, surgical site infections associated with ten common procedures decreased by 19 percent.
  • Between 2011 and 2013, hospital-onset C. difficile infections were reduced by 10 percent.
  • Between 2011 and 2013, the hospital-onset methicillin-resistant Staphylococcus aureus bacteremia infections fell 8 percent.
  • Between 2009 and 2013, catheter-associated urinary tract infections (CAUTIs) were lowered by 6 percent.

 

Second, Medicare launched the Hospital-Acquired Condition (HAC) Reduction Program.  The program tracks all patient discharges, assigning each hospital a score based on the occurrence of HACs.  By law, Medicare reduces its payments by one percent to any hospital in the bottom quartile of HAC scores.

These recent improvements are nothing if not encouraging,  Hospital-acquired infections, however, are still a very real threat–and, unfortunately, a common occurrence.  BridgeHealth strives to protect its plan members from this threat by building its own high-performance surgical network.  This network only includes the top quarter of hospital providers by utilizing the Comparion CareChex Hospital Quality Rating widely regarded as the best and most accurate measure of hospital quality.  This system determines the safest hospitals based on such metrics as patient safety, patient satisfaction, complications, and mortality, as well as clinical categories such as overall medical care, overall surgical care, overall hospital care, cancer care, joint replacement, hip fracture repair, and other concerns [4].  What this means is that BridgeHealth plan members receive the highest quality of hospital care.

BridgeHealth combines these high standards for surgical programs and hospital providers with pre-negotiated, bundled case rate pricing to offer the best in health care coverage: Plan members and their plan sponsors actually save money while minimizing the risk of HAIs, post-surgery complications, and adverse effects.

  1. http://www.cdc.gov/hai/surveillance/progress-report/index.html  – Healthcare-associated Infections (HAI) Progress Report, by the Centers for Disease Control and Prevention
  2. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-12-18-2.html – Hospital-acquired Condition Reduction Program by Centers for Medicare & Medicaid Services
  3. http://www.fiercehealthcare.com/story/cdc-report-indicates-progress-hai-reduction/2015-01-15 – CDC report indicates progress on HAI reduction
  4. http://www.carechex.com/ScoringRatingMethods.aspx – Hospital Quality Scoring and Rating Methods, Comparion Carechex