CDC: Health Facility Cooperation Needed to Fight Infection

CDC: Health Facility Cooperation Needed to Fight Infection

Antibiotic-resistant bacteria cause 2 million illnesses and 23,000 deaths each year in the United States, according to CDC estimates, and treatment options are increasingly limited. A recent study published in the CDC’s Morbidity and Mortality Weekly Report says better coordination of infection-control efforts between healthcare facilities would be more effective in slowing their spread.

The study looked at three bacteria that have become resistant to antibiotics: methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE) and Pseudomonas aeruginosa. It also looked at C. difficile, which can flourish when antibiotics kill off a patient’s protective bacteria. The researchers developed data models to compare how a coordinated approach to stopping the spread of these bacteria would fare compared to independent, facility-based approaches.

The researchers’ models—which represented both large-scale and small-scale healthcare networks—showed that a coordinated approach, if adopted now, could prevent more than 619,000 healthcare-associated infections and 37,000 deaths over 5 years.

The coordinated approach the researchers modeled allowed for all healthcare facilities to share test results with a central public health authority, which would use that information to strategically target prevention activity across multiple facilities. It also incorporated more frequent notification of patients' infection status to facilities receiving patients as transfers.

See www.cdc.gov/mmwr.

Half of U.S. Hospitals Will Pay Medicare’s Readmission Penalties

Once again, the majority of the nation’s hospitals will be penalized by Medicare for having patients frequently return within a month of discharge, Kaiser Health News reported. Some 2,592 hospitals will lose a combined $420 million via reduced Medicare payments starting in October.

This is the fourth year of penalties under the federal Hospital Readmissions Reduction Program. During that time, national readmission rates dropped, but an estimated one in five Medicare patients sent to the hospital still ends up being readmitted within a month.

On average, the penalties are slightly less severe than they were last year, and fewer hospitals will be penalized. They will affect hospitals in every state except Maryland, which has an alternative payment arrangement with Medicare.

The 2,232 hospitals that will avoid penalties didn’t necessarily have better readmission rates. Most were exempted from the program because they treat specific populations or had too few cases for Medicare to accurately evaluate.

Medicare Trustees Report Mixed

As Medicare marked its 50th anniversary, its trustees issued a report saying the program’s hospital trust fund will be solvent until 2030. The report also noted that Medicare’s long-term outlook has improved. That was the good news.

The less-welcome news was that several million Medicare beneficiaries could see their monthly Part B premiums increase by 52% in 2016, from $104.90 to $159.30.

The increase will affect 30% of Medicare beneficiaries, including:

• 2.8 million new enrollees;
• 3.1 million with incomes over $85,000 a year; and
• 1.6 million who pay premiums directly (vs. via Social Security deduction).

HHS Secretary Sylvia M. Burwell has said she will make a final decision on rates in October.

U.S. Health Spending Growth Rate Forecast at 5.8% for 2014–2024

Total healthcare spending growth is expected to average 5.8% in aggregate over 2014–2024, according to a report by the Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary (OACT). The authors noted that this is substantially lower than the 9% average rate seen in the three decades before 2008.

“Growth in overall health spending remains modest even as more Americans are covered, many for the first time. Per-capita spending and medical inflation are all at historically very modest levels,” said CMS acting administrator Andy Slavitt. “We cannot be complacent. The task ahead for all of us is to keep people healthier while spending smarter across all categories of care delivery so that we can sustain these results.”

Other findings from the report:

• 2014 U.S. health spending is projected to have reached $3.1 trillion, or $9,695 per person, an increase of 5.5%
• over 2013.
• Prescription drug spending increased 12.6% from 2013 to 2014, the highest growth since 2002.
• Medical price inflation was 1.4%. Hospital, and physician and clinical services, also increased slowly, by 1.4% and 0.5%, respectively.
• Annual growth in per-enrollee expenditures in 2014 for private health insurance (5.4%), Medicare (2.7%) and Medicaid (-0.8%) remained slow in historical terms.
• Per-capita premium growth in private health plans is projected to slow to 2.8% in 2015, reflecting the expectation of somewhat healthier marketplace enrollees and the increasing prevalence of high-deductible health plans offered by employers.

Source: CMS.gov. “2014–2024 Projections of National Health Expenditures Data Released.” www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-07-28-2.html

$38 Million Awarded to Improve Health Information Sharing

The Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) announced 20 awardees for three health information technology (health IT) grant programs totaling about $38 million.

• Advance Interoperable Health Information Technology Services to Support Health Information Exchange – $29.6 million to 12 states or state-designated entities expanding the adoption, capabilities and use of health information exchanges.
• The Community Health Peer Learning Program – $2.2 million to AcademyHealth to work with 15 communities on population health. The communities must identify data solutions, accelerate local progress, disseminate best practices and help inform national strategy around population health challenges.
• The Workforce Training Program – $6.7 million to seven grantees to update training materials and train incumbent healthcare workers to use new health information technologies in a variety of settings.

Project ECHO Gets $14 Million GE Foundation Grant to Expand Access to Care

The GE Foundation will award $14 million over three years to help increase the number of federally qualified health centers (FQHCs) participating in Project ECHO® (Extension for Community Healthcare Outcomes). In addition, Project ECHO will partner with the Institute for Healthcare Improvement to design and implement a quality-improvement ECHO program to support FQHCs in improving effectiveness and efficiency.

Through ECHO, community-based primary care providers train in a select specialty area, such as HIV/AIDS or behavioral health, so patients can get needed specialty care in their own communities. Project ECHO also links community providers via videoconference with specialist care teams at academic medical centers to manage patients who require complex specialty care. “This support from the GE Foundation will help make access to high-quality specialty care a reality for people in rural and underserved communities,” said Sanjeev Arora, MD, FACP, FACG, Project ECHO’s creator. "In the process, it will save and improve many, many lives.”