AHRQ Electronic Newsletter, June 30, 2015, Issue #476

June 30, 2015, Issue #476 AHRQ Stats: Medicaid "Super-Utilizer" Patients Among Medicaid patients younger than 65 in 2012, mood disorder was the most common diagnosis for “super-utilizers” — those with four or more hospital stays. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #190: Characteristics of Hospital Stays for Super-Utilizers by Payer, 2012.) Today's Headlines: Changes Needed for Success, Survival of Safety-Net Hospitals, AHRQ Report Concludes AHRQ Study: Cost Transparency Affects Patient Choice for Cataract Surgery AHRQ Study: Insufficient Evidence About Value of Negative-Pressure Therapy for Chronic Wound Care at Home Register Now: July 15 Webinar on Implementing Shared Decision-Making in Varied Practice Settings Register Now: July 15 Webinar Introducing the AHRQ Ambulatory Surgery Center Survey on Patient Safety Culture Register Now: Diagnostic Error in Medicine 8th International Conference in September, July 3 Call for Abstracts Deadline Approaching Featured Impact Case Study: AHRQ’s RED Toolkit Helps VA Hospitals in California and Texas Lower Readmissions, Improve Discharge Process Changes Needed for Success, Survival of Safety-Net Hospitals, AHRQ Report Concludes Safety-net hospitals and systems face increasing financial and competitive pressures as government funding decreases and performance expectations rise, according to a recent report funded by AHRQ. The study showed that system redesign and alignment of internal operations with market and other external challenges could help safety-net facilities fulfill their missions under ever more challenging conditions. A research team from Boston University conducted case studies in eight safety-net systems to examine the challenges and resource needs safety-net hospitals and systems face. Among the study’s conclusions: success and survival in today’s changing health care environment will require safety-net systems to achieve systemwide improvements in quality and efficiency and position themselves to obtain additional sources of revenue. Even with these changes, safety-net hospitals are likely to continue to require substantial government support to help them meet their obligations to care for indigent patients. Hence, it is important for policymakers and other stakeholders to seek a new consensus on the continuing role of safety-net systems under health reform, according to the study, “System Redesign Responses to Challenges in Safety-Net Systems: Summary of Field Study Research.” AHRQ Study: Cost Transparency Affects Patient Choice for Cataract Surgery Patients in California chose ambulatory surgery centers over more expensive hospital outpatient departments for cataract removal surgery when they knew the costs of care, according to an AHRQ-funded study. The researchers looked at the impact of “reference-based benefits,” a new employer-based health insurance design that encourages patients to select lower-priced freestanding ambulatory surgery centers rather than hospital outpatient facilities. Analyzing this type of benefit design for cataract removal surgery from 2009 to 2013 among groups of California patients, researchers found that total employer and employee payments per procedure fell by 19.7 percent compared with those without reference-based benefits. Researchers compared data on 2,347 surgical patients ages 18 to 64 covered by the California Public Employees Retirement Systems (CalPERS) and data from 14,867 patients enrolled in non-CalPERS Anthem Blue Cross plans, which do not use reference-based benefits. With reference-based pricing, employers set a pricing cap on the maximum amount they will cover for certain medical services that have wide cost variations. The article and abstract, “Reference-Based Benefit Design Changes Consumers' Choices and Employers' Payment for Ambulatory Surgery,” appeared in the March issue of the journal Health Affairs. AHRQ Study: Insufficient Evidence About Value of Negative-Pressure Therapy for Chronic Wound Care at Home Existing evidence is insufficient to draw conclusions about the efficacy and safety of negative-pressure wound therapy for the treatment of chronic wounds in the home setting, an AHRQ-funded study has concluded. While the use of such therapy is increasing, the researchers identified multiple gaps in research. The primary one is a need for standardized methods to define wound eligibility, outcome measures and interventions. The article and abstract, “Negative Pressure Therapy Technologies for Chronic Wound Care in the Home Setting,” appeared online April 2 in the journal Wound Repair and Regeneration. Register Now: July 15 Webinar on Implementing Shared Decision-Making in Varied Practice Settings AHRQ will host a webinar July 15 from 12:30 to 1 p.m. ET to discuss how a variety of health care organizations — ranging from a busy primary care clinic in an urban hospital to a network of small clinics in rural communities — have implemented shared decision-making in their respective settings. The webinar will address: An array of different approaches to the implementation of shared decision-making, each tailored to the unique needs of a specific institution; Challenges encountered throughout the implementation process and creative strategies for overcoming them; and Lessons learned along the way. Determination of continuing education credit through Professional Education Services Group is pending. Registration is open. Register Now: July 15 Webinar Introducing the AHRQ Ambulatory Surgery Center Survey on Patient Safety Culture AHRQ is hosting a webinar on July 15 from 3:30 to 4:30 p.m. ET about the AHRQ Ambulatory Surgery Center Survey on Patent Safety Culture.This new measurement tool provides a means for staff in ambulatory surgery centers to provide opinions about the culture of patient safety in their facilities, enabling them to assess areas of strength and identify areas for improvement as part of their own quality improvement activities. During the session, speakers will present results from the 2014 Ambulatory Surgery Center Pilot Study and introduce available toolkit materials. In addition, survey users will share their experiences using the survey and plans to improve their patient safety culture. Speakers: Jim Battles, Ph.D., Senior Service Fellow, AHRQ Center for Quality Improvement and Patient Safety, Rockville, Maryland Scott Smith, Ph.D., Senior Study Director, AHRQ Surveys on Patient Safety Culture, Westat, Rockville, Maryland (Moderator and Presenter) Erin Brown, R.N., Director of Nursing Services, Digestive Health Clinic and Idaho Endoscopy Center, Boise, Idaho Terry Tinsley, R.N., Clinical Nurse Manager, Underwood Surgery Center, Orlando, Florida Registration is open. If you have any questions, contact the Surveys on Patient Safety Culture team via email or call 1-888-324-9749. Register Now: Diagnostic Error in Medicine 8th International Conference in September, July 3 Call for Abstracts Deadline Approaching AHRQ Director Richard Kronick, Ph.D., will deliver a keynote address at the Diagnostic Error in Medicine 8th International Conference on September 28 in Washington, D.C. The call for abstracts has been extended to July 3, and those interested are invited to send submissions addressing the epidemiology of diagnostic error, predisposing factors for diagnostic error and strategies to detect or reduce diagnostic error. The conference is scheduled for September 27 to 29. Registration is open.