National Health Reform Provisions and PSOs

The following article was published in the spring 2012 Center for Patient Safety PSO News regarding national health reform provisions and PSOs:

UPDATE: ACA PSO Participation Requirement Delays Until January 2017.  Read more.

National Health Reform & PSOs

Two provisions within the expansive Patient Protection and Affordable Care Act (PPACA) health reform legislation include Patient Safety Organization (PSO) activities.

1. Beginning January 1, 2015, PSO participation will be required for a hospital to be eligible to join defined health plans that are part of health insurance exchanges. PPACA Section 1311 requires states to have health insurance exchanges in place by January 2014, and, beginning January 2015, for hospitals with more than 50 beds to have an established Patient Safety Evaluation System (PSES) in place.

2. PPACA Section 399KK calls for the federal Agency for Healthcare Research and Quality (AHRQ) to develop a program supporting PSOs in helping hospitals with high readmission rates improve their performance. It also requires PSOs and hospitals to report on processes to improve readmission rates.

Nationwide, the Department of Health and Human Services (HHS) has identified 631 hospitals, including 13 in Missouri, as needing improvement.

The AHRQ has posted information about the PSO Readmission Program containing the PPACA requirements and readmission reduction resources.

In addition, the AHRQ has released draft Common Data Formats for readmission data to be reported to PSOs for approval of the National Quality Forum. More details are expected to be provided by AHRQ about the PSO Readmission Program in 2012.

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