The Michigan Health & Hospital Association joins a growing list of hospital associations, states and payers who have adopted policies to stop billing patients for certain serious preventable errors ("never events") and hospital-acquired conditions. This follows on from Medicare's decision to cease payment from 2008, for specific hospital medical errors.

Pennsylvania Health Care Cost Containment Council (PHC4) recently released their second hospital-specific report on hospital-acquired infections. This report illustrates an increase in the rate of infections contracted by inpatients. There are some differences in the report on mortality, length of stay, and average hospital charges among patients with or without hospital-acquired infections.

Pittsburg Post Gazette reports Pennsylvania Health Care Alliance recently launched a Web site (www.phcqa.org) to assist the public in making more informed health care choices.

Fierce Healthcare: In 2006, nearly 1,500 patients died due to medical errors in Pennsylvania, according to a newspaper analysis of hospital billing records. Such deaths are an estimate of what the state would not be paying for if its new "no pay for preventable errors" Medicaid policy had been in place since then--and what the state is likely to uncover when it stops paying for such errors in the future.

The following is a summary of legislation by state regarding the disclosure by hospitals of their hospital infection rates.

Arkansas

Following on from news that PA lawmakers were approving legislation requiring hospitals and nursing homes to report patient infections to state authorities (as blogged on 7/16) - KaiserNetwork today reports that Govenor Rendell last Friday signed this bill into law.

iHealthBeat reports that Pennsylvania lawmakers recently approved legislation that will require hospitals and nursing homes in the state to report patient infections to state authorities.

The measure, part of the governor's "Prescription for Pennsylvania" health care agenda, aims to reduce insurance premiums by cutting the number of infections patients contract through increased monitoring.

An interesting report just released by the Pennsylvania Health Care Cost Containment Council found that hospitals in Pennsylvania that paid most to perform cardiac bypass surgery had lengths of stays and death rates comparable to the lowest-paid hospitals. In the first report of its kind, the Pennsylvania Health Care Cost Containment Council (PHC4) released hospital-specific average insurance and Medicare payments for cardiac surgery performed in the Commonwealth. The new report (Cardiac Surgery in Pennsylvania 2005) is an expansion of PHC4's coronary artery bypass graft (CABG) report, which now includes additional information about valve procedure cases. This report includes outcomes for in-hospital mortality, 30-day mortality, 7-day and 30-day readmissions and post-surgical length of hospitalization.

As reported in Philly.com, hospital officials in Pennsylvania agree on the need to reduce infections acquired in their institutions but oppose efforts to require reporting them electronically via a single statewide system. The Hospital and Healthsytem Association of Pennsylvania deem such technology as "very costly" particularly for small hospitals, and many hospitals require help for investing in information technology.

An interesting news item in PhillyBurbs.com today: Doylestown Hospital and Aetna announced an agreement this week that will give the hospital bonuses if it meets goals for patient care. The deal would reward the hospital for continuing its campaign to improve the care it provides to patients. Most of the U.S. health care system relies on a fee-for-service structure. Hospitals and doctors are paid according to the kind of health care they provide, not the quality of that care. The pay-for-performance agreement rewards hospitals that are better than their peers with bonus payments.

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Clostridium difficile infections are associated with nearly 21,000 PA hospitalizations in 2005, according to a new research brief released on Friday (5/11) by the Pennsylvania Health Care Cost Containment Council (PHC4). CDAD is a potentially life-threatening infection resulting from Clostridium difficile (often called C. diff), which is a spore-forming bacteria that can live in the intestine. The report does not distinguish between infections that are community-acquired or hospital-acquired.

In 2005, patients with CDAD were hospitalized two and a half times longer, charged more than twice as much and were four times as likely to die as patients without CDAD. Specifically, the mortality rates for patients with and without CDAD in 2005 were 8.7% and 2.1%, respectively. On average, patients with CDAD stayed in the hospital almost seven days longer than patients without CDAD. Whereas the average charge of a hospitalization with CDAD was $73,576, the average charge for a hospitalization without CDAD was $30,833.

Legislation introduced today by Representatives Rick Glazier, Martha Alexander, Lucy Allen, and Verla Insko falls short of what is needed to hold hospitals accountable for preventing patient infections, according to Consumers Union. HB 1738 establishes an advisory commission to develop recommendations for public reporting of hospital infection rates, but provides no guarantee that hospitals will be required to disclose such information.

Check out 'States with laws requiring hospital-acquired infection reporting' on StopHospitalInfections.org for a summary of state activity:

• 14 states have laws requiring public reporting of infection rates
• 2 states have laws requiring public reporting of infection information, but not specifically rates (CA, RI)
• 2 states have laws requiring confidential reporting of infection rates (NE, NV)

iHealthBeat reports on a bill that would require state pharmacies to submit the retail prices for the 150 most popular drugs and their generic equivalents in Pennsylvania. The bill would also create an online hospital payment registry of the most frequent admission diagnoses and dispensed drugs. Pennsylvania state Rep. Todd Eachus (D) has proposed a bill that would require hospitals and pharmacies in the state to post drug prices and hospital payments online in an effort to reduce health care costs and provide uninsured residents with easier access to affordable care.

Read the full news item at http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=132004