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A Quarter of Medicare Patients Experience Harm in Hospitals

Federal Insider: June 2022

A report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that in data analyzed from October 2018, 25% of Medicare patients experienced patient harm during their hospital stays. This is a slight decrease from OIG’s last report, based on 2008 data, that found 27% experienced harm. Nearly half of these events OIG considered preventable, and their cost to Medicare was estimated to be $325 million.

The OIG study divided harmful events into two categories. They considered adverse events those problems that led to longer hospital stays, permanent harm, life-saving intervention, or death.

Twelve percent of patients during the time period were affected by such issues. The second category was temporary harm, which covered events that required intervention but did not cause lasting harm, prolong hospital says, or require life-sustaining measures. These affected 13% of patients, and OIG noted that some of these were serious and could have caused further harm.

The most common type of harmful event was medication-related, at 43%. The remaining categories included patient care-related (23%), such as pressure injuries; procedures and surgeries (22%); and infections (11%).

“Although HHS agencies have reported progress during the past decade toward improving patient safety, protecting the health and safety of HHS beneficiaries remains one of HHS's top management and performance challenges,” OIG said.

The agency recommended that Medicare update and broaden its lists of hospital-acquired conditions to capture common, preventable, and high-cost harm events; explore expanding the use of patient safety metrics in payment structures; and develop interpretive guidance for surveyors assessing hospital compliance.

$5 Million Will Advance Equity in Cancer Screening at Health Centers

The Department of Health and Human Services (HHS) announced $5 million in funding for community health centers aimed at increasing equitable access to cancer screenings. HHS said the funding was part of the Biden administration’s Cancer Moonshot initiative.

“Cancer screening saves lives—and it should be accessible to all Americans,” said HHS Secretary Xavier Becerra. “In partnership with National Cancer Institute-designated cancer centers, we are giving community health centers in underserved communities funding to provide life-saving cancer detection and referrals to treatment.”

The funding will focus on access to breast, cervical, and colorectal cancer screening, areas in which HHS reported disparities based on an individual’s race or ethnicity, income, and insurance status. With support from National Cancer Institute-Designated Cancer Center partners, the funding also will help ensure that these patients have hands-on assistance accessing high quality cancer care and treatment, HHS said.

The Biden administration’s Cancer Moonshot aims to reduce the death rate from cancer by at least 50% over the next 25 years. Its areas of focus include improving diagnostics, preventing cancer with cancer vaccines, dealing with inequities in care, and targeting treatments using genetics and immunology.

A Record 35 Million People Enroll in Affordable Care Act Coverage

The uninsured rate has approached an all-time low, in part due to record numbers of people enrolling in Affordable Care Act (ACA) plans, according to the Department of Health and Human Services (HHS). Combining the total enrollments for Medicaid expansion, ACA marketplace coverage, and related state programs, enrollment reached an all-time high in early 2022.

About 21 million of the total comes from people in states and territories who gained healthcare coverage due to the ACA's expansion of Medicaid to low-income adults under 65. These high enrollments have been pushing down the uninsured rate, which in the fourth quarter of 2021 reached a nearly all-time low of 8.8% for the full population, compared to 10.3% in the fourth quarter of 2020.

The administration also sees additional state expansion of Medicaid as a path to advance healthcare equity. Of the nearly 4 million uninsured Americans who could gain coverage if additional states expanded their Medicaid programs, more than half are people of color, according to HHS data.