As important as expanding medical insurance is, there are a number of additional aspects of the PPACA that are intended to improve the quality of and reduce the cost of medical care. And these provisions are virtually unknown to anyone outside of the healthcare industry.
Sections of the law were devoted to reducing Medicare patient readmissions to the hospital in the immediate 30 days after discharge. Hospital readmissions have long been known as a potential indication of poorly managed medical care and have remained stubbornly high for years. Obamacare included a program called the Hospital Readmissions Reduction Program (HRRP) that penalized hospitals for excessive 30 day readmission rates for several common conditions.
Before the PPACA the 30-day hospital readmission rate for Medicare patients was around 19%. Immediately after implementation of the HRRP, 30-day hospital readmission rates fell markedly, particularly for the targeted conditions. Since the enactment of HRRP to today it is estimated that over 500,000 hospital readmissions have been avoided.
Conditions that patients acquire while hospitalized are another important measure of the quality of medical care. Unfortunately medically ill patients in the hospital can develop untoward urinary tract infections, pressure ulcers (bed sores) and adverse drug events. While hospital-acquired conditions (HACs) are not completely avoidable, there are many steps healthcare providers can take to reduce their risk.
The Affordable Care Act legislation established a Medicare and Medicaid Innovation Center to test models to improve care and lower costs. In 2011 one of the projects of the innovation center established a public-private partnership to make care safer and improve care transitions called the Partnership for Patients (PfP).
The PfP implemented payment incentives around reducing hospital-acquired conditions and it appears to have been remarkably successful. Between 2010 and 2015 there has been a 21 percent decline in HACs so that there are almost 1 million fewer annual incidents of harm in American hospitals. It is hard to overstate how impressive this improvement in hospital-acquired conditions has been. It is estimated that HAC reductions have led to nearly 125,000 fewer patient deaths in hospitals and a savings of approximately $28 billion since the ACA enacted the PfP program.
Stunning numbers that are never mentioned in the the sad political debate over Obamacare.