Dive Brief:
- The Office of Inspector General (OIG) has released its 76-page work plan for fiscal year (FY) 2016, which summarizes new and continuing OIG reviews of the U.S. Department of Health and Human Services (HHS) programs and operations.
- There are five areas the organization will review next year to ensure hospital quality care and safety is maintained.
- The first, which is new, will be to check the extent of CMS validation of hospital inpatient quality reporting data, which is used for hospital value-based purchasing and acquired condition reduction programs, requiring accuracy and completeness.
Dive Insight:
The second item OIG will review is how well hospitals comply with contingency planning requirements of the HIPAA. Third is hospitals' preparedness and response to high-risk infectious diseases. The final two are similar in that OIG will estimate national levels of adverse and temporary harm events for Medicare beneficiaries and factors contributing to those events, identify which events were preventable and associated costs to Medicare; one will be for inpatient rehabilitation facilities and the other for long-term-care hospitals.
Patient safety continues to be a top concern for HHS. A 2010 OIG report found 13.5% of hospitalized Medicare beneficiaries suffered from at least one serious adverse event during their hospital stay - 44% of those events were preventable and caused by care failures such as medication errors, substandard care, or inadequate monitoring. The report concluded with recommendations, one of which was "government, which pays for a large portion of the nation's medical care, must hold hospitals accountable for better care."
The report also recommended, "CMS should provide further incentives to hospitals to reduce the incidence of adverse events." OIG had determined in the report adverse and temporary harm events cost Medicare $4.4 billion per year.