IHA Daily Briefing: July 11

Thursday, July 11, 2019
Study on Malpractice Cases Resulting in Harm
HFS Issues Provider Notices on Reimbursement
U.S. House Committee Advances Healthcare Bills
Register: IHA/JCR High Reliability, Leadership Workshop
Briefly Noted

Study on Malpractice Cases Resulting in Harm
More than one-third (34%) of malpractice cases resulting in serious harm is due to inaccurate or delayed diagnosis, according to a new study appearing Thursday in the journal Diagnosis. Researchers from the Johns Hopkins University School of Medicine and CRICO Strategies also found that 74% of inaccurate or delayed diagnoses that result in permanent disability or death are attributable to three disease categories: cancer, vascular events and infections.

"It is not just inconvenient to have a wrong or delayed diagnosis. For many patients, misdiagnosis causes severe harm and expense, and in the worst cases, death," David Newman-Toker, MD, PhD, professor of neurology and the director of the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence, who conducted the research. "If we're going to reduce serious harms from medical errors, major strides must be made to improve diagnostic accuracy and timeliness."

The research was funded by the Society to Improve Diagnosis in Medicine through a grant from the Gordon and Betty Moore Foundation.  See a press release about the study.

The federal Agency for Healthcare Research and quality has prioritized reducing harm from diagnostic error as one of the three essential areas to improve patient care and has set a goal of reducing the more than 12 million diagnostic errors that take place each year by 10%.

IHA's Midwest Alliance for Patient Safety Patient Safety Organization (MAPS PSO) supports research and collaboration on the impact of diagnostic errors on patient safety.  In response, MAPS PSO joined the Society to Improve Diagnosis' Coalition to Improve Diagnosis. This group consists of more than 40 of the nation's leading healthcare and patient advocacy organizations leading the effort to decrease diagnostic errors.  As a part of this initiative, MAPS has held webinars and provided resources to its members to discuss this complex issue. Click here for more information.

Similarly, IHA's Insurance Solutions is focused on reducing diagnostic error by working with hospital and physician clients to improve the diagnostic process. Through the Risk Exposure Adjustment Program (REAP), members of IHA's Illinois Provider Trust are incentivized to address factors that lead to error. REAP criteria is focused on raising awareness among providers, the importance of engaging patients and families, and building an infrastructure to better support the diagnostic team and to improve diagnostic accuracy and timeliness.


HFS Issues Provider Notices on Reimbursement
The Illinois Dept. of Healthcare and Family Services (HFS) has issued two important provider notices. The first notice informs providers that the new inpatient and outpatient pricing calculators have been updated to include reimbursement changes effective July 1. The second notice informs providers that the new hospital rate sheets (effective July 1) have been posted to the Hospital Reimbursement Notifications webpage.


U.S. House Committee Advances Healthcare Bills
The U.S. Energy and Commerce Subcommittee on Health today advanced numerous bills, including several that would: reauthorize expiring health and workforce programs; delay cuts to the Medicaid disproportionate share hospital program; and prevent surprise medical bills—No Surprises Act.

IHA is strongly opposed to the No Surprises Act, which is sponsored by committee leaders and would establish a "benchmark" rate (defined as the median in-network payment rate in a geographic area) for certain out-of-network care. While IHA supports protecting patients from surprise medical bills, we oppose government rate-setting because it would threaten hospital resources and incentivize health plans to create narrow networks.

IHA continues to urge the Illinois congressional delegation to support a dispute resolution process, such as arbitration, to resolve payment disputes between providers and health plans. See our letter here.

Members are asked to contact your Representative and Senators to express strong opposition to government payment rate-setting or requiring doctors to join the same networks as hospitals. See our alert and talking points here.

The following bills passed the subcommittee and could be considered by the full committee as early as next week:

  • H.R. 2781: EMPOWER for Health Act;
  • H.R. 728: Title VIII Nursing Workforce Reauthorization Act;
  • H.R. 1058: Autism CARES Act;
  • H.R. 2507: Newborn Screening Saves Lives Reauthorization Act;
  • H.R. 776: Emergency Medical Services for Children Program Reauthorization Act;
  • H.R. 2035: Lifespan Respite Care Reauthorization Act;
  • H.R. 2296: FAIR Drug Pricing Act;
  • H.R. 2328: Community Health Investment, Modernization, and Excellence Act;
  • H.R. 3631: Territories Health Care Improvement Act; and
  • H.R. 3630: No Surprises Act.

Register: IHA/JCR High Reliability, Leadership Workshop
Becoming a high-reliability organization is not just about standardization. It's an ongoing process that requires leadership commitment.

Learn the strategies that can benefit every hospital at IHA's upcoming workshop, High Reliability and Medical Staff Leadership. The July 31 course—with video conferencing between IHA's Naperville and Springfield offices—is co-hosted with The Joint Commission Resources (JCR) as part of their Continuous Service Readiness® (CSR®) program.

Two JCR consultants, Steven D. Chinn, DPM, MS, and Eric Brown, MD, PhD, will provide attendees with a deeper understanding of:

  • The components of high reliability;
  • Tactics for successful implementation;
  • Accreditation requirements for medical staff; and
  • New standards impacting medical staff.

Dr. Chinn has more than 30 years of clinical and management experience and is currently Interim Patient Safety Officer and Administrative Director of Accreditation and Regulatory Affairs at Stanford Health Care. Dr. Brown is a former chief medical officer with experience in quality improvement and risk management. He was also Medical Education Program Director at Rush University Medical Center in Chicago.

This one-day workshop will benefit managers, directors and executives in:

  • Quality improvement;
  • Patient safety;
  • Risk management;
  • Hospital operations; and
  • Medical staff services.

Hospitals and health systems that are not current subscribers to JCR's CSR program can send staff to attend the workshop for a fee.

This program is a valuable opportunity to improve your organization's resilience and overall performance. For information on registration and continuing education credits, visit our event page.

Register today.


Briefly Noted
Today, the Health Resources and Services Administration (HRSA) presented 10 states, including Illinois, with the 2019 Medicare Beneficiary Quality Improvement Project Quality Performance Awards. The awards recognize achieving the highest reporting rates and levels of improvement in Critical Access Hospitals over the past year. The states were noted for investing funding from HRSA's Federal Office of Rural Health Policy into quality improvement projects and developing technical assistance resources that improve high-quality care in their communities.

After Southern California’s powerful earthquakes last week, the Illinois Emergency Management Agency (IEMA) is reminding Illinoisans that there are two active seismic zones on the state’s western and eastern boarders and earthquake preparation is not just for the west coast. Read IEMA’s press release on how “Drop, Cover and Hold On” can prevent injury during an earthquake.

This week, Becker's Healthcare recognized 70 CEOs, presidents and administrators of critical access hospitals (CAHs) for innovation, quality and patient safety on the local and national level. Congratulations to the following six CAH leaders from Illinois: Dolan Dalpoas, president & CEO Abraham Lincoln Memorial Hospital; Jackie Kernan, president, OSF HealthCare Saint Luke Medical Center and OSF HealthCare Holy Family Medical Center; Mark Kuhn, CEO, Hammond-Henry Hospital; Patricia Luker, president and CEO, OSF HealthCare Holy Family Medical Center; Dawn Trompeter, president, OSF HealthCare Saint Paul Medical Center; and Karissa Turner, president and CEO, Wabash General Hospital.