Six quality issues warrant the attention of healthcare leaders: misdiagnoses, star ratings, socioeconomic adjustment for readmissions, the end of Partnership for Patients programs, Medicaid parity expiration, and Disproportionate Share Hospital cuts.
Healthcare has experienced fascinating changes during the last few years, and 2015 will be no exception.
Major programs stemming from the Patient Protection and Affordable Care Act are well under way, dozens of new quality measures and data galore are flowing into the public domain, and quality of care remains in the spotlight for providers at all levels.
There are sure to be tweaks, especially where measures and performance commingle to affect payment. But here are six quality issues that warrant your attention in 2015.
1. Measuring misdiagnosis
If physicians' diagnostic accuracy were like air travel, one in 20 planes would not land when or where it should, and one in 40 flights would put passengers at risk of significant harm, or even crash.
Those are estimations from an April 2014 report from Houston Veterans Affairs and Baylor College of Medicine researcher Hardeep Singh, MD, and colleagues who say that 12 million U.S. outpatient adults may be given incorrect or delayed diagnoses every year. Singh says reducing misdiagnosis must be a major quality focus for 2015 because providers and patients should not tolerate error rates this high.
Singh's report in BMJ Quality & Safety estimated that 5.08% of outpatients receive an inaccurate diagnosis, and that half of those errors have the potential to cause severe patient harm, such as a missed opportunity to treat cancer at an earlier, easier stage. These misdiagnoses can result in avoidable or extended hospitalizations or even death.
Though misdiagnoses may be a patient safety issue on a par with medication errors or infections, providers don't measure or track them. It can be hard to assign blame: sometimes patients don't know or fail to reveal relevant details. But sometimes the fault is the provider's, for failing to take an adequate history or conduct a proper physical exam.