News briefs: Patient safety; proposed Medicare increase; electronic records; slight profit margins
News briefs
HHS task force will target patient safety
Department of Health and Human Services (HHS) Secretary Tommy Thompson has announced that a new Patient Safety Task Force has been established within HHS that will coordinate a joint effort among several agencies to improve existing systems to collect data on patient safety.
These agencies include the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration). HHS’ fiscal 2002 budget proposal includes up $72 million, an increase of $15 million over fiscal year 2001, for efforts to improve patient safety and reduce the number of adverse events.
In addition, Thompson has charged the task force with studying how to implement a user-friendly Internet-based patient safety reporting format. The group will develop computer networks, user-friendly reporting systems, and standards for coding the content of the reports, reports AHA News. The system will feature a uniform data collection method. The Centers for Disease Control and Prevention and the Food and Drug Administration will provide data on medical errors, while the Agency for Healthcare Research and Quality will analyze the causes of medical errors.
CMS proposes increase in rates for hospitals
Hospitals across the United States would see a 2.55% increase in Medicare payment rates in fiscal year 2002, according to a proposed rule issued by the Centers for Medicare and Medicaid Services (CMS, formerly the Health Care Financing Administration) in Baltimore and published in the May 4 Federal Register. The proposed increase, which would become effective Oct. 1, 2001, will affect about 4,800 acute care hospitals that are paid under the prospective payment system (PPS). The proposed rule also contains provisions to implement a number of mandates in the Medicare, Medicaid, and State Children’s Health Insurance Program Benefits Improvement and Protection Act of 2000, which will also become effective Oct. 1, 2001. Among these is a proposed mechanism to facilitate access to high-cost new services and technologies by authorizing special payments to cover increased costs.
The proposed rule also makes a number of revisions to DRG classifications. For example, the proposed rule would create two new pancreas transplant DRGs and would create new DRGs for cardiac defibrillator cases and percutaneous transluminal coronary angioplasty cases.
In addition, the proposed rule provides for a three-year hospital geographic wage index reclassification, the use of three-year averages of the average hourly wages in qualifying for geographic reclassification, and the option to use a statewide index instead of individual wage indexes for the geographic area of a state. CMS plans to publish a final inpatient PPS rule by Aug. 1, for implementation Oct. 1, 2001.
Hospital to study effect of electronic records
The University of Colorado Hospital in Denver has announced two new grants for controlled studies of how patient care is affected by electronic access to medical records. The announcement of The Commonwealth Fund gift of more than $282,000 plus a significant grant from CaP CURE was made at a University of Colorado Hospital Authority Board of Directors meeting by Dennis Brimhall, president and CEO.
With support from the Commonwealth Fund grant, researchers Steve Ross, MD, and C.T. Lin, MD, will manage a study of the effect of patient access to electronic medical records (EMRs) on the attitudes, expectations, and experiences of patients and physicians at a specialty clinic for heart failure at the hospital.
Researchers will conduct a controlled study of patients with congestive heart failure who are provided access to their EMRs via the Internet and will evaluate the effect of EMR availability on patients’ understanding of their conditions, their ability to provide self-care, and their confidence in the care they are receiving. Physicians’ views on medical record access also will be studied.
The grant from CaP CURE will help fund a study of about 30 prostate cancer support group members to determine how their use of the Internet affects their medical care. The grant will help patients communicate directly with their physicians at any time via the Internet. Michael Glode, MD, will direct that study.
Hospital profit margins show negligible increase
Operating profit margins at U.S. hospitals flattened at an annualized average of 3.69% in 2000, indicating only a slim degree of financial health, according to a report by Solucient, a provider of benchmark information on health care.
Hospital operating margins increased 0.41% over 1999 and remained relatively low, a full 36.6% lower than in 1997. Solucient president Gregg Bennett says margins of from 3% to 4% are not sustainable in the long run, especially given the pressure from increasing drug costs and hospital labor shortages. He also says hospitals are still feeling the sting of the 1997 Balanced Budget Act and its clamp on Medicare payments.
Other key findings from the study, "The Health of Our Nation’s Hospitals," include: Smaller hospitals finished the year best at 4.84%, their highest operating margin since 1997; larger hospitals produced the slimmest operating margins at 2.83%; regionally, western hospitals posted the weakest operating margins — 3.9%, while northeastern hospitals fared the best, going from break-even in 1999 to almost 5% in 2000. For more information, visit www.solucient.com.
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