Premier Inc. has announced the results of a study on Medicare hospital pay-for-performance, revealing improved quality of care, lower costs and declining patient mortality rates.
The San Diego-based Premier Inc., serving some 1,700 U.S. hospitals and more than 49,000 other healthcare sites, conducted its analysis using the Centers for Medicare and Medicaid Services' Medicare data and the results of its own participation in the pay-for-performance project.
The study, touted by Premier as the broadest of its kind to date, shows that if all hospitals in the United States were to achieve what was accomplished under the CMS project, nearly 70,000 patient deaths could be prevented and as much as $4.5 billion in hospital costs could be saved annually.
The CMS project, known as the Hospital Quality Incentive Demonstration (HQID), set performance standards for hospitals treating patients with pneumonia, heart bypass, heart failure, heart attack and hip and knee replacements.
According to Premier, the median hospital cost per patient for participants in the HQID project declined by more than $1,000 across the first three years of the project and the median mortality rate decreased by 1.87 percent. The 1.1 million patient records analyzed for the study comprised 8.5 percent of all patients nationally within the five noted clinical areas over the three-year timeline.
Richard Norling, president and CEO of the Premier Healthcare Alliance, said a variety of factors contributed to the positive results, including a hospital's desire to improve. Leaders at top-performing hospitals spend 25 percent of their time on quality improvement, he said, and successful hospitals have a continuous dialogue between medical staff and leadership and tie executive compensation to quality performance.
Nick Turkal, MD, president and CEO of Aurora Health Care in Milwaukee, Wis., which also participated in the study, said the project helped his organization.
"We had a culture of quality improvement for many years, but this project changed our culture from one of incremental improvement to the pursuit of perfection," he said. "Things don't change unless you put in a structure to change them."
According to Mark Povroznik, director of quality initiatives and chairman of infection control at United Hospital Center in Clarksburg, West Va., also a participant in the project, the demo has been an impetus in the hospital's approach to quality and a formula for success. He links a direct decline in costs to participation in the project.
Evan Benjamin, MD, quality researcher and chief quality officer for Baystate Health in Springfield, Mass., said hospitals participating in P4P projects are able to achieve quality goals at a rate 5 percent higher than those participating in public reporting alone.
Benjamin said cost savings realized in the CMS P4P project are created through better care, which leads to fewer complications.