Are Hospital Patients Healthier Under Obamacare?

New changes to care mean less infection and fewer visits for patients, study shows.

An auxiliary nurse assists a patient in a geriatric unit at the hospital in Angers, western France, on October 23, 2013. The Angers hospital employs 6,000 people including 980 doctors.
National Journal
Clara Ritger
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Clara Ritger
May 7, 2014, 1:26 p.m.

Hos­pit­als are do­ing a bet­ter job at keep­ing pa­tients healthy, and it’s partly due to re­forms put in place by the Af­ford­able Care Act.

Hos­pit­als pre­ven­ted nearly 15,000 deaths and 560,000 in­jur­ies by re­du­cing ad­di­tion­al ill­nesses and in­fec­tions ac­quired in the hos­pit­al, pre­lim­in­ary data from the Health and Hu­man Ser­vices De­part­ment show. That would mean up­ward of $4 bil­lion in over­all health-spend­ing sav­ings between 2010 and 2012, ac­cord­ing to Wed­nes­day’s re­port.

There were also 150,000 few­er hos­pit­al read­mis­sions among Medi­care be­ne­fi­ciar­ies in 2012 and 2013, the Cen­ters for Medi­care and Medi­caid Ser­vices says, mean­ing that few­er pa­tients were hav­ing to go back to the hos­pit­al with­in 30 days of dis­charge in the last two years than between 2007 and 2011.

The im­prove­ments for pa­tients are dir­ectly re­lated to the Af­ford­able Care Act’s re­forms, ac­cord­ing to HHS and the Amer­ic­an Hos­pit­al As­so­ci­ation. The Af­ford­able Care Act cre­ated the Cen­ter for Medi­care and Medi­caid In­nov­a­tion, which funds pro­jects aimed at re­du­cing health costs and im­prov­ing out­comes for pa­tients.

Among the pro­grams cre­ated by CMMI is the Part­ner­ship for Pa­tients, a pub­lic-private ini­ti­at­ive with the goal of re­du­cing hos­pit­al-ac­quired con­di­tions by 40 per­cent and hos­pit­al read­mis­sions by 20 per­cent between 2010 and 2014. In­fec­tion and read­mis­sion rates are tied to hos­pit­als’ Medi­care pay, so there’s a strong in­cent­ive for hos­pit­als to im­prove out­comes for pa­tients.

To get to that goal, hos­pit­als are mak­ing changes to the way they in­ter­act with pa­tients, the Amer­ic­an Hos­pit­al As­so­ci­ation said. Hos­pit­als call pa­tients after they leave the hos­pit­al to make sure that their re­cov­ery plan is clear and that they have a way to get their med­ic­a­tions. Hos­pit­als are also fol­low­ing up with primary-care phys­i­cians to make sure a pa­tient’s health is on track.

An­oth­er big change hos­pit­als are mak­ing is to not al­low moth­ers to de­liv­er ba­bies be­fore they’re due, which re­duces risk. Rates of early elect­ive births de­clined 64.5 per­cent between 2010 and 2013.

“If you de­liv­er earli­er, you have a high­er like­li­hood of com­plic­a­tions,” said Mau­l­ik Joshi, the pres­id­ent of the Health Re­search and Edu­ca­tion­al Trust at the Amer­ic­an Hos­pit­al As­so­ci­ation. “The res­ults in a short peri­od of time are really phe­nom­en­al.”

While some of these prac­tices were in place in hos­pit­als pri­or to the Af­ford­able Care Act, ac­cord­ing to the AHA, only now are the changes ac­cel­er­at­ing across the na­tion.

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