Live long enough, and you’re more likely than not to require a surgical procedure. You’ve probably been experiencing pain, going to the doctor, missing out on life activities. But you and your physician have made a decision, you’re going to go ahead with the surgery. Now you’ve selected your surgeon, made arrangements with your employer, your family, and maybe even started planning out your rehab and recovery activities. You feel good about your preparations, and your procedure is probably something routine, or at least seems routine to the surgical teams that do this type of work day in and day out. You’ll be fine, but hospitals can be dangerous places.
According to the Center for Disease Control, there were an estimated 721,800 Hospital-acquired infections (HAI’s), in 2011. Of these, about 75,000 patients (more than 1 in 10) died during their hospital stay . Very dangerous places indeed.
Now, there is some good news. First, these numbers have gotten the attention of policy makers and in 2014, Medicare launched the Hospital-Acquired Condition (HAC) Reduction Program . This new program tracks all patient discharges and gives each hospital an HAC score. By law, this program requires that medicare reduce payments owed to the hospital by one percent if the hospital in question ranks in the quartile of hospitals with the highest (worst) HAC scores.
Second, Hospital-acquired infection rates have been falling. In 2014 the CDC released a progress report that included data compiled by over 14,500 healthcare facilities nationwide on the fight against HAI’s. According to the progress report, there was..
• A 46 percent decrease in central-line-associated bloodstream infections from 2008-2013
• A 19 percent decrease in surgical-site infections in 10 select procedures from 2008-2013
• A 6 percent increase in catheter-associated urinary tract infections (CAUTI) from 2009-2013
• An 8 percent decrease in hospital-onset methicillin-resistant Staphylococcus aureus bacteremia from 2011-2013
• A 10 percent decrease in hospital-onset C. difficile infections from 2011-2013
While these improvements of late are encouraging, Hospital-acquired infections are still a very dangerous, and unfortunately common occurrence. BridgeHealth takes this threat to it’s Plan Members very seriously, and in response, BridgeHealth has built its own High Performance Surgical Network which only includes hospital providers ranked in the top 25% nationally according Comparion CareChex Hospital Quality Rating tool. The CareChex system uses a number of statistical methods to calculate scores and ratings based on quality measures within categories such as mortality, complications, patient safety, patient satisfaction, etc., and clinical categories such as overall hospital care, overall medical care, overall surgical care, hip fracture repair, joint replacement, cancer care and many others . The bottom line is that CareChex is widely regarded as the most accurate quality rating method currently available to compare hospital providers and hospital care.
By combining pre-negotiated bundled case rate pricing, together with the highest-quality surgical programs through a specialized surgery network of hospital providers, BridgeHealth has the potential to save Plan Members and their Plan Sponsors money on major surgical procedures, while also minimizing adverse effects, post-surgery complications and Hospital-acquired Infections.
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