BALTIMORE – Nephrologists joining the fight with other Medicare physicians and legislators to eliminate the archaic sustainable growth rate, which governs what Medicare pays physicians, can point out that the Medicare program itself has tightened its belt. The per capita growth in Medicare payments for patients in the program has been the lowest in history over the last four years, noted CMS deputy director Patrick Conway during a talk for the Renal Physicians Association here.
Likewise, 30-day hospital readmission rates are down for all causes at around 17%. “That means over 130,000 patients are staying home” that would have ended up back in the hospital, Conway said. U.S. Renal Data System data indicates that among prevalent hemodialysis patients in 2011, 36% of discharges from the hospital were followed by a re-hospitalization within 30 days.
Conway said Medicare has also seen a 41% reduction in central line bloodstream infections at over 1,000 intensive care units across the country. The rates for hospital-acquired conditions went down 9% across all measures from 2010-2012.
The results, said Conway, fit in with the six priorities of CMS as part of its National Quality Strategy that reward providers and health systems that deliver better outcomes at lower cost to both patients and Medicare. The NQS’s three aims include:
Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social and environmental determinants of health in addition to delivering higher quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.
The six priorities Conway mentioned that are used to direct the NQS’s aims are:
- Making care safer by reducing harm caused in the delivery of care.
- Ensuring that each person and family is engaged as partners in their care.
- Promoting effective communication and coordination of care.
- Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
- Working with communities to promote wide use of best practices to enable healthy living.
- Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.
Improving the quality of care means defining the end goal, not necessarily the process for achieving it,” said Conway. “We need to make major investments in quality improvement.”
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