Patient Safety Awareness Week: Health Plans’ Role

by Alicia Caramenico

March 17, 2016

Far too many patients are harmed as the result of preventable events that occur during the course of receiving medical care. Patient Safety Awareness Week, an initiative of the National Patient Safety Foundation (NPSF), is a time to reflect on the health insurance community’s focus on the crucial patient safety implications of avoiding preventable hospital admissions, readmissions, hospital-acquired conditions, and emergency room visits.

By preventing avoidable hospital admissions and protecting patients from the risks associated with inpatient settings, we can make sure patients are getting the care they need on an outpatient basis to stay healthy and avoid complications that could send them back to the hospital. Health plans have been bringing patient safety programs to the delivery system, working together with the public sector and other industry stakeholders to reduce hospital admissions and prevent hospital-acquired infections. These programs emphasize collaborating with patients and their families to take an active role in getting safe, effective, quality care. They also involve measuring performance so that patients and clinicians have the information they need to make good decisions about their health care.

We can look to Medicare Advantage plans for examples of activities that are reducing readmission rates, improving quality, and protecting patients from harm. Some of these include helping patients transition smoothly from the hospital to their homes and better managing their chronic conditions, offering 24/7 nurse hotlines so patients with non-urgent medical problems can find safe alternatives to emergency rooms, and having case managers on staff to help patients make follow-up appointments and take medications correctly.

Research shows these interventions consistently lead to improved health outcomes and serve as a foundation for quality improvement innovations across the health care system.

Health plans will continue to implement patient-centered initiatives and innovative payment models that move our delivery system toward higher quality and improved patient safety. We look forward to continued partnership with all stakeholders on this important responsibility.