(Story updated at 4:09 P.M. ET)
A new effort to curb adverse events in hospitals and cut readmissions will replace and expand hospital engagement networks, or HENs. A similar but more ambitious initiative known as the hospital improvement and innovation networks or HIINs is now looking for interested providers.
The CMS Wednesday said HIINs will be tasked with a 20% decrease in overall patient harm and a 12% reduction in 30-day hospital readmissions through 2019.
Providers involved in a HEN can compete for a place in the HIINs, the CMS said in its request for proposals.
The 17 HENs, first created in 2011, were a group of more than 3,000 hospitals. Together, they worked to reduce the rates of 10 types of harms such as patient falls and pressure ulcers and readmissions over three years. The effort was part of the $1 billion Partnership for Patients initiative, which involved thousands of hospitals, agencies, consumer groups in both the public and private sector. The CMS renewed the effort in 2015 for one year.
The agency touted the program's overall success, stating that last year, 50,000 fewer patients died, 1.3 million adverse events were avoided and $12 billion was saved at hospitals because of reductions in hospital-acquired conditions from 2010 to 2013. However, the 17% decline in hospital acquired conditions fell short of the 40% goal set by HHS.
HHS previously said reaching those initial targets could have resulted in 1.6 million fewer readmissions, 1.8 million fewer patient injuries and 60,000 lives saved over the program's three-year span. HHS also predicted Partnership for Patients could save Medicare as much as $50 billion over a decade.
But in addition to the failed goals, there were concerns about tracking the progress of some HENs.
At issue is the quality of the metrics the CMS used, said Dr. Ashish Jha, director of the Harvard Global Health Institute.
In response, the CMS renewed the effort for only one year last year and said it was beefing up reporting requirements and reducing the amount of providers participating.
In 2011, the agency awarded $110 million in contracts to the 17 hospitals and health systems. The program initially was 26 HENS and $218 million.
The CMS will oversee the HIINs effort, unlike HENs, more broadly under the CMS as part of the Quality Improvement Organization (QIO) initiative. HENs were overseen by the Center for Medicare & Medicaid Innovation, which was created to test innovative payment and service delivery models.
The shift infers that despite not meeting HHS goals, the HENs were successful enough to continue on a more permanent basis, said Michael Millenson, president of the Highland Park, Ill., consulting firm Health Quality Advisors.
While HIINs may seem similar to its predecessor, the program will formally collaborate with quality improvement organizations (QIO), said Lorraine Ryan, senior vice president, Legal, Regulatory, and Professional Affairs at the Greater New York Hospital Association, which participated in a HEN.
QIOs are composed of health quality experts, clinicians and consumers aimed at improving Medicare, according to the CMS.
A CMS spokesperson confirmed the name change was meant to signify the integration of the HENs into the QIO program.
The agency said HIINs will recruit 4,000 hospitals.
Former HEN providers were relatively pleased with the results of their experiment.
“We remain deeply committed to this work," said Premier spokesperson Amanda Forster, adding that she hoped to see the initiative meet new needs in local communities.
A spokeswoman from the American Hospital Association agreed and said it too would apply to continue on as a HIIN.
Millenson said he hoped the new effort would allow for more transparency and evaluation as HENs "was plagued with questions about data and standardization."
No budget was released for the HIINS contracts. Responses are due by June 27.
