D.C. Week: Hospitals Now Get Graded
WASHINGTON -- Hospitals will now be ranked by letter grade for how well they perform on safety measures; internists flocked to Washington this week to lobby for reimbursement reform; and pharmacy groups protested a possible reclassification of drugs containing hydrocodone.
New Rankings for Hospitals
For the first time, hospitals across the nation have been given letter grades indicating how well, or poorly, they perform on measures of patient safety, and the American Hospital Association isn't happy about it.
The Leapfrog Group, a nonprofit quality-improvement organization, has ranked more than 2,600 hospitals and given them scores based on an "A, B,C, D, or F" scale for hospital safety on its free site Hospitalsafetyscore.org.
Of the 2,652 hospitals issued a safety score by Leapfrog, 729 earned an A, 679 earned a B, and 1,243 earned a C or below. The American Hospital Association (AHA) disputed Leapfrog's ratings, arguing that many of the measures used to determine the grades are flawed.
Internists Lobby Congress
Several hundred internists and medical students were on Capitol Hill Thursday, meeting with their members of Congress to advocate for issues facing internal medicine.
Chief among them, not surprisingly, is a fix for the sustainable growth rate (SGR), the Medicare formula that, year after year, calls for steep cuts in Medicare reimbursement rates for physicians. Doctors' groups -- including the American College of Physicians (ACP), which represents internists -- as well as several lawmakers, have been pushing for bills to totally revamp the formula, which both Democrats and Republicans agree is flawed.
Fred Ralston, MD, an internist in Fayetteville, Tenn., and former president of the ACP, told MedPage Today that he doesn't expect a permanent SGR fix to happen this year, but that doesn't mean physicians should stop pressing the issue. Sen. Max Baucus (D-Mont.), said in an interview that he's been "a little disappointed over the years that we haven't found a better formula to reimburse physicians."
Pharmacy Groups Oppose Reclassification of Hyrdocodone
Pharmacy groups voiced their opposition to an amendment in the Senate's FDA user fee reauthorization bill that would reclassify all medications containing hydrocodone as Schedule II drugs.
The Senate provision, drafted by Sen. Joe Manchin (D-W.Va.), would reclassify hydrocodone-containing combination products as Schedule II controlled substances, a category reserved for drugs with medical uses that have a high potential for abuse and may lead to severe psychological or physical dependence.
Hydrocodone in pure form and any formulations of hydrocodone combination products containing more than 15 mg hydrocodone per dose are already classified as Schedule II drugs, for which prescriptions cannot be phoned in and a new prescription is needed for each refill.
Manchin's amendment would add products in which hydrocodone in smaller doses is combined with other drugs, such as acetominophen (Vicodin). Those combination products are currently classified as Schedule III drugs, which are defined as drugs that have a lesser potential for abuse, and also carry a lower risk of addiction.
"While we share your concerns regarding the abuse and diversion of these prescription drugs, and we appreciate your leadership on this unfortunate situation, these concerns must be balanced with the impact on patients who legitimately need access to these products," wrote the American Pharmacists Association, the Food Marketing Institute, the International Academy of Compounding Pharmacists, the National Association of Chain Drug Stores, and the National Community Pharmacists Association in a May 30 letter sent to Manchin and congressional leaders.
CEOs Write Checklist for Better Care
Eleven health systems have joined with the Institute of Medicine to develop a checklist to help provide better quality care with lower cost.
The list, developed by leaders of healthcare organizations including the Cleveland Clinic and Geisinger Health System, includes 10 strategies that have been "proven effective and essential to improving quality and reducing costs." They deal with foundational, infrastructure, care delivery, and feedback components of a healthcare system.
"As demand for high-value healthcare builds, care delivery leaders face the near-term imperative to transform the way their organizations operate," the authors of the checklist wrote. "We know the potential for improvement exists."
Next Week
The House is in recess next week.
On Wednesday, the FDA's Circulatory System Devices Panel will make recommendations on the Edwards Sapien Transcatheter Heart Valve for use in patients with symptomatic severe aortic stenosis who have high operative risk. Sapien is already approved for use in high-risk patients who were considered inoperable or unable to undergo open heart surgery.
On Thursday, a Senate Homeland Security and Governmental Affairs subcommittee will hold a hearing on efforts to saving taxpayer dollars by curbing waste and fraud in Medicaid. The same day, the Senate Finance Committee will hold a hearing on "Medicare Physician Payment Policy: Lessons from the Private Sector."
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