It's Impossible to Know What $1B in Federal Quality Spending Buys

Cheryl Clark, February 20, 2014

A pair of quality initiatives say they are preventing harm and saving lives, but their data is lacking, two prominent patient safety and health policy experts contend.

From the jubilant tone of two recent announcements, one might be relieved to know that hospital safety and quality have improved by leaps and bounds in the last few years.

First, some 1,500 hospitals participating in the federally funded Hospital Engagement Network (HEN) say they have prevented hospital-associated harm in 69,000 patients in the program's first two years, with cost savings of $201 million.

This single HEN, one of 26 in the federal Partnership for Patients initiative, has reduced or prevented readmissions, infections, blood clots, and pressure ulcers, says Rich Umbdenstock, president of the American Hospital Association whose trust operates this HEN with a share of $1 billion in federal funds authorized by the Affordable Care Act. Their "hard work is really paying off," he said.

Second, Premier Inc.'s Quest Collaborative of 352 hospitals boasted last week that its programs prevented an expected 136,375 deaths over five years and saved $11.65 billion. Premier officials said this 38% reduction was based on incident rates at the baseline, which "outpaced the national average."

But both claims have two prominent leaders in hospital quality shaking their heads.

"These statements about how many lives and costs are saved are encouraging because it's what policy makers and providers all want," says Peter Pronovost, MD, senior vice president for patient safety and quality at Johns Hopkins Hospital. "But the underlying designs of these programs all have problems that make such statements about savings extremely challenging."

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