Today’s Quality and Cost Council meeting looked at how to measure potential preventable hospital readmissions, how to elect its leadership, and how to be an independent agency.
Potentially Preventable Readmissions, or PPRs, have long been a concern for the QCC and were highlighted as a critical step in last year’s Roadmap to Cost Containment. The discussion was kicked off by Dr. Dana Gelb Safran, co-chair of the QCC’s Expert Panel for Performance Measurement (EPPM), which assesses the readiness of new statistical measures. Safran discussed the EPPM’s recommendation that existing measures of hospital readmission were not sufficiently reliable to use in public reporting or to determine levels of reimbursement. The EPPM recommended that they embark on a study of the upcoming National Quality Forum measure, with disclosure by some tool in place by 2012. Several members of the QCC spoke up, including Beth Capstick of the Auditor’s office who said “this is not just about hospitals; it is about how we care for people,” adding that she gained a fuller appreciation of the issue when a family friend was readmitted to a hospital seven times between Thanksgiving and her death four months later.
The QCC decided, after lengthy discussion, that they will use a new National Quality Forum (NQF) statistical measure that is expected to be released within a month to report hospital data on potentially preventable readmissions as soon as feasible, which could be as early as this fall.
The QCC also discussed a Chapter 288 mandate requiring it to appoint an executive director. Council members Gregory Sullivan and Dolores Mitchell interpreted the mandate as requiring the QCC to hire a new executive director from outside the agency, as part of the legislature’s general scheme to make the QCC a more independent agency. However, other members of the council suggested changing the duties of the current administrative director to make it an executive director position. Inspector General Sullivan cautioned that such a move might make the QCC “a nominal entity that is subsumed within the executive agency and that doesn’t seem to jive with the general ideas that are contained in the legislation.”
QCC members also expressed concern that the legislature did not set a budget for the executive director position. The QCC budget currently falls under a larger earmark and the legislature assumed the QCC would receive about $400,000 next year.
The QCC also passed new bylaws, including procedures for the selection of an executive committee. The bylaws create a nominating committee of QCC members to suggest candidates, but allow all QCC members to nominate their own candidates and to vote on who will fill each proposed position. The QCC also heard reports from a quality and safety committee, discussed new requirements under Chapter 288 and approved an almost $60,000* contract to hire a company to support its “My Health Care Options” website.
*Note – amount corrected on 9/16