In The News

Government as a Platform for Progress: HHS’s Open Government Plan

By: Mary K. Wakefield, Ph.D., RN, HHS Acting Deputy Secretary

One of the first actions President Obama took after taking office was to direct federal agencies to find new ways to increase transparency, collaboration and public engagement. Since then, one of our top priorities at HHS has been to make our Department more open and accountable to the people we serve.

With the publication of our fourth HHS Open Government Plan, we’re building on our past performance in making government more transparent to the public and engaging in new ways of collaborating and partnering with our stakeholders. 

Read more: Government as a Platform for Progress: HHS’s Open Government Plan

Targeting cardiovascular disease risk factors may be important across a lifetime

NIH-funded study suggests efforts to prevent risk factors should extend to those older than 65.

Click here to read the full article

CMS Blog: The Medicare Current Beneficiary Survey: Celebrating Our 25th Anniversary and a Bright Future Ahead

http://blog.cms.gov/2016/09/29/the-medicare-current-beneficiary-survey-celebrating-our-25th-anniversary-and-a-bright-future-ahead

September 29, 2016

By Niall Brennan, Chief Data Officer, CMS

This year marks the 25th anniversary and the one millionth beneficiary interview for the Medicare Current Beneficiary Survey (MCBS), a survey that the Centers for Medicare & Medicaid Services (CMS) first fielded in 1991. This in-person survey of 15,000 Medicare beneficiaries collects valuable information about aspects of the Medicare program that cannot be analyzed based on CMS administrative data alone. In particular, the MCBS gathers information on self-reported health status, satisfaction with care, and functional limitations. The MCBS also collects information on beneficiaries that is key to understanding patient-centered care. Beneficiary’s out-of-pocket spending and source of payment for medical services received outside the Medicare program provides a window into the “invisible” and missed costs of health care. One unique aspect of the MCBS is that it includes beneficiaries who reside in institutional settings, such as a nursing home, as well as those in the community.

The MCBS is used across CMS to provide important insights that support internal program analyses. For example, over the past several years, the MCBS has become a key resource for evaluating the impact of CMS Innovation Center demonstration models as well as for approving Medicare Advantage and Prescription Drug Plan benefits.

The MCBS also serves as the foundation for thousands of health policy analyses across a diverse external user community. To date, we know of more than 1,000 peer-reviewed papers based on MCBS data in leading publications such as the New England Journal of Medicine, the Journal of the American Medical Association, Journal of Health Economics, and the Journal of the American Geriatrics Society.

Today, I want to acknowledge a number of important efforts CMS has undertaken to ensure the MCBS remains a valuable resource for the agency and external stakeholders. We have made the data more accessible, releasing the first ever MCBS public use file in May of this year. While MCBS data files have always been available for a relatively nominal fee, we heard that this fee was a barrier to entry for certain users such as students. We believe that increased access through this freely available public resource will expand the MCBS user community, and thus help cement its importance as a critical tool in the evaluation of systemic changes in the US health care delivery system.

We are also implementing changes to the MCBS questionnaire and survey design. Revising and improving the survey questions is underway. We have added new relevant content including an updated dental utilization module, a module on care coordination, and new questions on food security. Enhancing the sampling methodology to include newly enrolled beneficiaries in the first year of their Medicare enrollment, conducting an oversample of Hispanic beneficiaries, and, beginning in 2017, conducting an oversample of low-income beneficiaries increase our ability to conduct disparities research and improve our survey estimates.

We are also committed to a more rapid data release schedule, with improved user documentation and file structure. The 2015 MCBS files will be the first to have many of the improvements discussed above. We anticipate releasing the 2015 data file in the 2nd quarter of 2017, more than one year earlier than the previous file release schedule. The release of the 2015 data will also include improved chart books to accompany data releases and more intuitive naming conventions and file layouts with modern file formats for SAS, Stata, and R use. However, to accommodate these long overdue innovations, we had to make the difficult decision not to release 2014 data files.

As we celebrate our 25th anniversary of the MCBS, we are renewing our commitment to providing the most useful and relevant information about the Medicare program and, more importantly, the health and satisfaction of its beneficiaries.

We hope that you’ll visit us on our MCBS webpage at https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/MCBS/index.html where you can also subscribe for important updates and announcements.

New National Quality Strategy Priorities in Action

Two new Priorities in Action are featured on the National Quality Strategy's (NQS) Web site. The Priorities in Action series features some of our Nation's most promising and transformative quality improvement programs, and describes their alignment to the Strategy's six priorities.

  • Researchers at Indiana University designed the Geriatric Resources for Assessment and Care of Elders (GRACE) Team model as a solution to the health and health care challenges faced by low-income seniors with multiple chronic conditions. Their efforts promote effective communication and care coordination, one of the NQS six priorities, through the NQS levers of Innovation and Diffusion and Learning & Technical Assistance.
  • Better Health Partnership addresses the prevalence of heart disease in Ohio by developing and partnering with programs across the State that align with core principles of ongoing national health care delivery system reform efforts. The Partnership's efforts promote the prevention and treatment of the leading causes of morbidity and mortality, one of the six NQS priorities, through the NQS levers of Public Reporting and Innovation & Diffusion.

If your program aligns with the priorities, email NQStrategy@ahrq.hhs.gov with details.

Making Progress on Combating Antibiotic Resistance

September 19, 2016
By: Sylvia Mathews Burwell, HHS Secretary

This week, Secretary Burwell is traveling to New York City to address the United Nations General Assembly at a High-Level Meeting focused on antibiotic resistance. It’s a chance to share the progress we’ve made in combatting resistance, the direction we’re headed, and how important global cooperation is to global health – all points that the Secretary highlights in her blog post below.

– Kevin Griffis, Assistant Secretary for Public Affairs

***

Most of modern medicine is possible because antibiotics gave us the power to fight common infections. Unfortunately, we’ve seen this tool’s power gradually diminish over time. Every year, at least 2 million people become infected with antibiotic-resistant bacteria, and 23,000 die as a result.

To find a solution to this public health challenge, President Obama tasked HHS to work with our federal partners on a comprehensive, five-year National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB).

To put this plan into action, the CARB Task Force, which includes the Departments of Defense and Agriculture, has been working to implement the National Action Plan for over a year now. So I wanted to take this opportunity to share some of our progress.

Read more: Making Progress on Combating Antibiotic Resistance

CMS Blog: New data: 49 states plus DC reduce avoidable hospital readmissions

http://blog.cms.gov/2016/09/13/new-data-49-states-plus-dc-reduce-avoidable-hospital-readmissions

September 7, 2016

By Patrick Conway, M.D., principal deputy administrator and chief medical officer, CMS; and Tim Gronniger, deputy chief of staff, CMS

The unfortunate experience of having to return to the hospital after recently being treated—or watching the same thing happen to a friend or family member—is all too common. Potentially avoidable hospital readmissions that occur within 30 days of a patient’s initial discharge are estimated to account for more than $17 billion in Medicare expenditures annually.[1]  Not only are readmissions costly, but they are often a sign of poor quality care. Many readmissions can be avoided through improvements in care, such as making sure that patients leave the hospital with appropriate medications, instructions for follow-up care, and follow-up appointments scheduled to make sure their recovery stays on track.

To address the problem of avoidable readmissions, the Affordable Care Act created the Hospital Readmissions Reduction Program, which adjusts payments for hospitals with higher than expected 30-day readmission rates for targeted clinical conditions such as heart attacks, heart failure, and pneumonia. The Centers for Medicare & Medicaid Services has also undertaken other major quality improvement initiatives, such as the Partnership for Patients, which aim to make hospital care safer and improve the quality of care for individuals as they move from one health care setting to another.

The data show that these efforts are working. As described below, between 2010 and 2015, readmission rates fell by 8 percent nationally. Today, CMS is releasing new data showing how these improvements are helping Medicare patients across all 50 states and the District of Columbia. The data show that since 2010:

  • All states but one have seen Medicare 30-day readmission rates fall. [2]
  • In 43 states, readmission rates fell by more than 5 percent.
  • In 11 states, readmission rates fell by more than 10 percent.

Readmissions Data 

Across states, Medicare beneficiaries avoided almost 104,000 readmissions in 2015 alone, compared to if readmission rates had stayed constant at 2010 levels. That means Medicare beneficiaries collectively avoided 104,000 unnecessary return trips to the hospital. Cumulatively since 2010, the HHS Assistant Secretary for Planning and Evaluation estimates that Medicare beneficiaries have avoided 565,000 readmissions.

The Hospital Readmissions Reduction Program is just one part of the Administration’s broader strategy to reform the health care system by  paying providers for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality. Other initiatives include Accountable Care Organizations, as well as efforts by Quality Improvement Organizations and Hospital Engagement Networks, which fund quality improvement expert consultants to work with provider and hospital communities to improve care. The goal of all of these efforts is to spend our health care dollars more wisely to promote better care for Medicare beneficiaries and other Americans across the country.

State

2010

2015

% Change in Readmission Rates

Reduction in readmissionsin 2015 compared to 2010 

Hospital Admissions

Readmission Rate

Hospital Admissions

Readmission Rate

AK

9,809

14.50%

9,954

13.70%

-5.50%

-78

AL

154,856

17.20%

143,210

16.20%

-5.80%

-1,503

AR

103,056

17.70%

92,562

16.60%

-6.20%

-993

AZ

135,293

16.60%

128,061

14.80%

-10.80%

-2,270

CA

574,176

17.60%

547,558

16.60%

-5.70%

-5,580

CO

83,346

14.20%

81,822

12.90%

-9.20%

-1,099

CT

109,888

18.10%

96,492

16.70%

-7.70%

-1,306

DC

23,907

20.00%

23,194

18.50%

-7.50%

-346

DE

29,827

17.40%

32,257

15.60%

-10.30%

-575

FL

619,368

18.20%

588,187

17.70%

-2.70%

-3,161

GA

209,500

17.50%

191,485

16.20%

-7.40%

-2,453

HI

16,824

14.90%

15,799

12.90%

-13.40%

-315

IA

100,490

15.50%

91,256

14.50%

-6.50%

-910

ID

25,432

12.50%

28,139

12.20%

-2.40%

-78

IL

421,395

19.80%

335,610

17.40%

-12.10%

-8,108

IN

210,919

17.40%

186,241

16.10%

-7.50%

-2,474

KS

90,545

16.30%

87,224

14.70%

-9.80%

-1,361

KY

162,249

19.70%

132,511

17.90%

-9.10%

-2,384

LA

129,123

18.70%

112,328

16.90%

-9.60%

-2,013

MA

208,356

19.00%

197,649

17.90%

-5.80%

-2,213

MD

189,323

21.10%

170,510

18.90%

-10.40%

-3,789

ME

43,450

16.10%

38,571

15.50%

-3.70%

-232

MI

343,346

18.60%

280,152

18.00%

-3.20%

-1,767

MN

129,642

15.70%

130,725

14.60%

-7.00%

-1,435

MO

203,685

18.20%

174,677

16.90%

-7.10%

-2,311

MS

106,281

19.10%

96,252

17.60%

-7.90%

-1,469

MT

27,962

13.90%

27,518

13.10%

-5.80%

-231

NC

269,108

17.00%

235,283

15.90%

-6.50%

-2,472

ND

26,562

15.40%

26,650

14.40%

-6.50%

-267

NE

60,007

15.70%

56,791

14.40%

-8.30%

-735

NH

36,189

15.70%

39,871

15.30%

-2.50%

-152

NJ

281,282

20.30%

250,924

17.60%

-13.30%

-6,774

NM

36,209

15.20%

33,016

14.80%

-2.60%

-118

NV

51,787

18.00%

52,308

17.00%

-5.60%

-529

NY

491,897

19.90%

402,439

17.80%

-10.60%

-8,407

OH

325,091

18.80%

267,743

16.80%

-10.60%

-5,405

OK

119,346

17.40%

106,073

15.60%

-10.30%

-1,878

OR

58,182

14.30%

61,393

14.20%

-0.70%

-75

PA

369,418

18.10%

324,166

16.60%

-8.30%

-4,995

RI

24,142

19.00%

24,705

17.00%

-10.50%

-487

SC

130,950

16.50%

125,993

15.50%

-6.10%

-1,237

SD

31,269

14.90%

30,806

13.20%

-11.40%

-515

TN

207,875

18.40%

180,666

16.80%

-8.70%

-2,905

TX

571,147

17.10%

509,738

16.10%

-5.80%

-4,960

UT

33,534

12.20%

38,142

11.50%

-5.70%

-261

VA

207,241

17.50%

211,674

16.40%

-6.30%

-2,302

VT

15,439

15.30%

16,332

15.40%

0.70%

21

WA

130,798

15.30%

131,817

14.20%

-7.20%

-1,388

WI

137,336

15.60%

124,274

14.50%

-7.10%

-1,373

WV

70,144

19.90%

60,630

18.60%

-6.50%

-777

WY

13,277

15.10%

12,838

14.20%

-6.00%

-110


[1] Jencks, S. F., Williams, M. V. and Coleman, E. A. (2009). 'Rehospitalizations among patients in the Medicare fee-for-service program'. New England Journal of Medicine, 360 (14), 1418-1428.

[2] The readmission rate in Vermont was virtually unchanged, increasing slightly from 15.3% in 2010 to 15.4% in 2015. This change correlates to 21 additional readmissions compared to if the state’s rate had remained constant.

AHRQ Data Identify States That Rank Highest in Health Care Quality

Maine, Massachusetts, Wisconsin, New Hampshire and Minnesota were the nation's top-performing states for health care quality, according to AHRQ's updated State Snapshots. The snapshots are an interactive online resource that provides state-level data showing how all 50 states and the District of Columbia performed on more than 250 measures related to health care quality and access. Drawn from AHRQ's 2015 National Healthcare Quality and Disparities Report, the State Snapshots show how each state fared according to National Quality Strategy priorities, prevalence of diseases and conditions, health status of priority populations, insurance status, access to care, type of care and setting of care. While the 2015 report shows progress nationwide in access and care affordability, the State Snapshots reveal substantial variations across states and sizable disparities related to race, ethnicity, income and other factors. Learn more about AHRQ's State Snapshots, which offer easy-to-read charts on the strengths, weaknesses and opportunities for improvement in each state.

New analysis shows consumers will still have affordable health coverage options next year

An estimated 73 percent of HealthCare.gov consumers could still purchase a plan for less than $75 per month, even if all final rates were to increase by double digits

Since the Affordable Care Act became law, health care prices have risen at the lowest rate in 50 years, and premiums for the 150 million Americans with employer-sponsored insurance have grown at some of the slowest rates on record. Today, a new HHS analysis finds that HealthCare.gov consumers would continue to have affordable coverage options, even if all Marketplace final health insurance premium rates were to increase by double digits next year. In a hypothetical scenario where all rates increase by 25 percent, the vast majority of consumers (73%) would be able to purchase coverage for less than $75 per month, according to today’s report. All Marketplace premiums will be finalized and public in October.

Read more about today's announcement.

NIH review finds nondrug approaches effective for treatment of common pain conditions

U.S. study reviews trial results on complementary health approaches for pain relief; aims to assist with pain management.

Click here to read the full article.