Why So Little Coverage of Improvement?

By Susan Carr

On May 7, the Dept. of Health and Human Services (HHS) reported on the effects of federal efforts to decrease the rates of hospital-acquired conditions (HACs) and readmissions. These efforts, implemented through a system of Hospital Engagement Networks (HENs), have been supported with funding from the Affordable Care Act (ACA), starting with grants to the HENs in October 2011. The funding was designed to continue for two years, plus a third if results showed improvement, which they have. In last week’s report, HHS credits the program for preventing15,000 deaths and 560,000, as well as reducing the rate of hospital readmissions (within 30 days of discharge) over the past two years.

These are important improvements. Why, then, has there been so little coverage of this announcement? With admittedly cursory online searches of The New York Times, The Boston Globe, The New England Journal of Medicine, JAMA, The Healthcare Blog, and the Health Affairs blog, I found no coverage of the HHS report. Kaiser Health News, on the other hand, published an excellent article by Jordan Rau.

The data are difficult to define, understand, and report. HHS has attempted to personalize the story by extrapolating the data to lives saved and harm avoided, but the program still is not easy to understand. As has been true for years, the quality and safety of healthcare are improving, though too slowly, across many dimensions, and with so many exceptions, it’s difficult to see, quantify, and celebrate the results.

Another significant effect of this and other, overlapping federal programs is on reimbursement to hospitals—another complex story, but one that gets more coverage.

For background on federal improvement efforts, especially the HENs, see this on PSQH.com. For an excellent report about the financial implications of overlapping penalties for hospitals, see Cheryl Clark’s recent article.

To promote more discussion and coverage, I invite readers to report on their experiences with these federal improvement programs. You can always reach me at susan.psqh@gmail.com.