“We know that those are areas where big improvements can be made,” Corrigan says.
Also, providers can expect to see the government and other organizations looking more closely at patient-reported outcome measures such as activities of daily life and behavioral-health measures. Corrigan also says the emphasis on shared decisionmaking will continue to grow as the provisions of the Patient Protection and Affordable Care Act stress the importance of patient participation and engagement.
Finally, she says, stakeholders will be looking more closely at healthcare costs and maximizing value. “This is the year where we need to bring cost and quality together,” Corrigan says. “There are so many interventions that can be win-wins for lower costs and better quality for patients, and I think we're still trying to find that sweet spot.”
Russell Olmsted, president-elect of the Association for Professionals in Infection Control and Epidemiology, and an epidemiologist at St. Joseph Mercy Health System, Ann Arbor, Mich., also sees a continued focus on rates of healthcare-associated infections in 2011. Providers will see continued success in preventing central line-associated bloodstream infections, he says. But he also predicted they would struggle with multidrug-resistant organisms such as Clostridium difficile.
Perhaps the biggest shift in incentives for infection prevention occurred in July 2010, when the CMS announced it would tie a portion of its hospital quality reporting program to participation in the Centers for Disease Control and Prevention's National Healthcare Safety Network, a secure, online infection surveillance system.
According to the CMS, hospitals must begin submitting their rates of central line-associated bloodstream infections to the CDC's network this month to receive their full payment updates for 2013. “There's no question they will reach logarithmic levels in terms of the number of facilities participating in the NHSN,” Olmsted says. “My prediction is that CMS' incentive is a first step toward value-based purchasing.”
The next challenge, Olmsted adds, will be to make sure incidences of infection are adequately validated. “When a major payer like CMS is asking for infection rates, we want to make sure they are as precise as possible,” he says.