The nation's two biggest for-profit health insurers are taking different approaches to a patient-safety issue that struck the healthcare industry like a bolt of lightning in 1999.
A foundation created by UnitedHealth Group is spending about $8 million on an advertising campaign that some observers say blames providers for medical errors, and Aetna has awarded about $840,000 in grants to fund original research into patient safety and medical errors.
Both high-profile initiatives were triggered by the Institute of Medicine's now-famous report To Err is Human, which estimated that as many as 98,000 Americans die each year from medical errors.
"As the IOM study indicates, patient safety is a critical issue (and one) that the healthcare community must expand its effort to address," said John Kelly, M.D., Aetna's director of physician relations and the former director of the American Medical Association's quality division.
In January 2000, just one month after the December 1999 release of the IOM's report, Aetna and its not-for-profit foundation announced plans to provide up to $1 million in grants to study issues such as reducing medication errors, controlling infection in long-term-care facilities and improving safety for surgical patients.
Nine months later, after an expedited peer-review process, Aetna awarded the five grants through its affiliated Academic Medicine and Managed Care Forum, an alliance of 53 medical centers, teaching hospitals and pharmaceutical companies:
* $209,147 to the University of Washington, Seattle, for a "multidisciplinary approach to improving surgical-patient safety."
* $208,162 to Emory University, Atlanta, for research into a potential surveillance system for outpatient adverse drug reactions.
* $198,570 to the University of Alabama-Birmingham to study infection control for long-term-care facilities.
* $174,375 to the University of Texas-Houston School of Public Health for research into "improving medication safety by learning from experience."
* $50,000 to the Mount Sinai School of Medicine, New York, for the relationship between medication management and literacy in communities of older adults.
Meanwhile, UnitedHealth Foundation, created in 1999 through funding by UnitedHealth Group-with about 16 million members the country's second-largest insurer after Aetna-has launched an "educational campaign." It focuses on several patient-safety topics, including medical errors. The first part of the campaign, running in People and elsewhere, features ads against medical errors and is being criticized by some providers who claim the ad places blame on doctors and hospitals (See story, p. 4).
Both companies are battling in Congress against the American Medical Association, which supports a Democrat-sponsored patients' rights bill vigorously opposed by managed-care companies. Interestingly, both spokesmen for the two companies' patient-safety efforts-Kelly of Aetna and Reed Tuckson, M.D., vice president of UnitedHealth Foundation-were hired away from the AMA to help improve the insurers' relations with doctors.
A top official with Aetna's initiative wouldn't compare the different approaches by the two for-profit insurers, but he said he was gratified by "any attention brought to this issue in a constructive and positive way."
"The approach we've taken is a recognition that health plans have two unique assets," said Dennis Oakes, the executive director of the managed-care forum. "We have access to data and access to a national network of hospitals, physicians and other providers. These are tools that can be used to assist in a united approach (to patient safety).
The five studies all began last fall and will be completed within two years, said Aetna officials. Study results will be published in peer-reviewed journals.
Three months ago, Aetna, which has 18.3 million health plan members nationwide, became the first healthcare and group-benefits manager to join the Leapfrog Group, a coalition of Fortune 500 companies with purchasing guidelines based on encouraging more stringent patient-safety standards.
"In our role as a healthcare insurer, we will also promote awareness of the Leapfrog program among our participating hospitals," said William Popik, M.D., senior vice president and chief medical officer at Aetna, "and we will continue to develop additional patient safety enhancements for our existing programs."