HCI3's Measures to Improve Quality and Outcome of Care for Patients Endorsed by NQF

Reducing potentially avoidable complications can improve quality and reduce cost

WASHINGTON, Feb. 7, 2011 /PRNewswire-USNewswire/ -- Four potentially avoidable complication (PAC) measures from the Health Care Incentives Improvement Institute™, Inc. (HCI3™) have been endorsed by the National Quality Forum (NQF), a quality improvement and consensus standards setting organization. Reduction of PACs – preventable failures in care that cause harm to patients – can play an important role in U.S. reform efforts to move health care away from fragmentation, poor performance and dysfunction toward accountability for high-value care.

HCI3's PACs are already incorporated in PROMETHEUS® Payment, the organization's model for health care measurement and payment that rewards hospitals and physicians for coordinating and providing high-quality care. The NQF-endorsed PACs cover acute myocardial infarction (heart attack), pneumonia, stroke and six chronic conditions: diabetes, congestive heart failure (CHF), hypertension, chronic obstructive pulmonary disease (COPD), asthma and coronary artery disease (CAD).

"This endorsement is a significant step forward to creating a payment system that rewards professionals for the quality and efficiency of services, rather than quantity," said Francois de Brantes, executive director for HCI3. "Potentially avoidable complications consume a tremendous amount of dollars in addition to providing bad outcomes for patients. Our research and pilots show that lowering PACs improves quality and affordability of health care."

30% of U.S. health care dollars spent on PACs

HCI3's analysis of national claims data of more than 3.5 million commercially insured members under the age of 65 found that PACs account for up to 30 cents of every dollar in U.S. health care spending across six common chronic conditions: asthma, CAD, CHF, COPD, diabetes and hypertension. The analyses also shows wide variation in PAC costs between providers and across the country, suggesting that these costs can, in fact, be reduced. (1,2)

"These measures may eventually be adopted by employers to quantify the percentage of dollars they are spending on PACs to create programs with health plans and employees that reduce those costs over time," noted de Brantes. "In addition to cost savings, holding providers and plans accountable for reducing PACs has the potential to improve patients' experience with the care they receive."

The NQF endorsement is the outcome of more than a year of work during which HCI3's PAC measures were submitted to intense scrutiny by a number of NQF Technical Advisory Panels and Steering Committees.

The specific HCI3 measures endorsed by NQF in January 2011 are as follows:

1. Proportion of patients with a chronic condition that have a potentially avoidable complication during a calendar year.
2. Proportion of AMI patients that have a potentially avoidable complication (during the index stay or in the 30-day post-discharge period).
3. Proportion of stroke patients that have a potentially avoidable complication (during the index stay or in the 30-day post-discharge period).
4. Proportion of pneumonia patients that have a potentially avoidable complication (during the index stay or in the 30-day post-discharge period).

Health Care Incentives Improvement Institute™, Inc.

The Health Care Incentives Improvement Institute™, Inc. (HCI3™) is a not-for-profit multi-stakeholder umbrella organization for Bridges to Excellence, Inc. and PROMETHEUS Payment, Inc. The mission of the organization is to create significant improvements in the quality and affordability of health care by developing and implementing programs that recognize and reward physicians, hospitals and other health care providers that deliver safe, timely, effective, efficient, equitable and patient-centered care. HCI3 offers a comprehensive package of solutions to employers, health plans and coalitions to improve the flawed incentives that currently permeate the U.S. health care system. www.HCI3.org

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Francois de Brantes

http://www.profnetconnect.com/francois_de_brantes

(1) de Brantes, Francois, Rosenthal, Meredith A., and Painter, Michael. (2009) "Building a Bridge from Fragmentation to Accountability — The Prometheus Payment Model." New England Journal of Medicine 361:1033-1036. http://www.nejm.org/doi/abs/10.1056/NEJMp0906121

(2) de Brantes, Francois, Rastogi, Amita, and Painter, Michael. (2010) "Reducing Potentially Avoidable Complications in Patients with Chronic Diseases: The Prometheus Payment Approach." Health Services Research. 45: 1475-6773. http://dx.doi.org/10.1111/j.1475-6773.2010.01136.x

SOURCE Health Care Incentives Improvement Institute, Inc. (HCI3)