Outlook 2015: Quality and safety

(This article has been updated with a correction.)

The push for improved quality and safety metrics in healthcare will expand beyond the hospitals to the entire continuum of care in 2015. Safety leaders are broadening their focus to include outpatient centers, home-care facilities and dialysis clinics. And there will be increased attention to diagnostic errors.

There was momentum in this direction in 2014 as the CMS moved ahead with plans to adopt its star rating system across all Medicare.gov Compare websites. The program, which has rated nursing homes since 2008, was expanded to physician groups, kidney dialysis providers and home health agencies. Hospitals are expected to be added in the coming months.

Providers faced increasing penalties for poor performance in reducing hospital-acquired conditions. The CMS recently estimated that in 2015, overall Medicare payments would drop by about $330 million because of the HAC penalty program. In fiscal 2015, the HAC, readmissions reduction and value-based purchasing programs combined put 5.5% of inpatient Medicare payments at risk.

In 2015, the National Patient Safety Foundation plans to release a report analyzing where the U.S. stands on healthcare quality. “The main job is to figure out what's next,” said Dr. Don Berwick, the founder of the Institute for Healthcare Improvement who co-chairs the panel set up by NPSF to study the current state of patient safety and assess progress since the 1999 IOM report To Err Is Human. That panel may issue recommendations in late 2015. The Society to Improve Diagnosis in Medicine is planning a national campaign to increase awareness of the problem, and the National Quality Forum plans to issue a report in late 2015 on the role of health IT in patient safety, including factors leading to diagnostic errors.

In addition, the National Patient Safety Foundation's Lucian Leape Institute plans to release a white paper this year with recommendations on how providers can improve in four areas of transparency. Foundation President Dr. Tejal K. Gandhi said the report, expected to be issued in January, will focus on four areas including better communication between clinicians and patients about the risks of treatment.

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(This article has been updated to indicate that the National Patient Safety Foundation alone plans to release a report analyzing where the U.S. stands on healthcare quality. The Institute of Medicine is not involved.)