News in brief - April 16, 2001

New surgery standards issued - Pediatric group sues Aetna - Consumer-friendly quality measures - Grants go to primary care research - Patient safety research to be funded

New surgery standards issued

The Joint Commission on Accreditation of Healthcare Organizations in March launched a new accreditation program for office-based surgery practices.

The organization developed the surgery standards and survey process after consulting with practitioners, professional organizations and consumer advocacy groups. Input also was solicited through the organization's Web site (http://www.jcaho.org/). The standards emphasize safety and quality performance issues that affect patients and their care.

Customized for the practitioner's office from the Joint Commission's ambulatory care standards, the new office-based standards cover patient safety, patient care, improving care, staffing effectiveness, customer service and responsible leadership.

Joint Commission officials said accreditation also can be used to satisfy managed care contract requirements, encourage staff professionalism, lower liability insurance premiums and expedite third-party reimbursement.

For more information, contact Mike Dye at (630) 792-5259 or Linda Kelley Peterson at (630) 792-5198. You also can e-mail a request with the name, address and phone number of your organization. The standards can be viewed at the Web site. The manual, with eligibility requirements, can be ordered for $95 by contacting the Joint Commission's Customer Service Center at (630) 792-5800.

Pediatric group sues Aetna

It's not just the big guys taking on the HMOs anymore. The little guys, fed up with not getting paid, are challenging them, too.

A 12-pediatrician practice in Raleigh, N.C., in February filed a lawsuit against Aetna in Mecklenburg Superior Court that claims the company deliberately delayed payments to the doctors. Aetna owes the doctors at least $58,000, according to the claim. Faxes, certified letters and face-to-face meetings over the past 14 months produced some results. At one point, the insurer owed the doctors $160,000.

But Aetna hasn't paid anymore recently and talks were going nowhere, said Jerry Bernstein, MD, a pediatrician with the group.

"It's the principle," Dr. Bernstein said. "We were providing services to patients, and with the Aetna contract we expected payment for these services. ... If we don't pursue it, they've been successful."

Consumer-friendly quality measures

The National Committee for Quality Assurance has received grants from the Commonwealth Fund and the California HealthCare Foundation to explore consumer information needs on physician quality and to streamline physician group oversight in California.

The Commonwealth Fund grant supports a 21-month study to develop measures of physician quality based on input from consumers, purchasers and health care organizations.

NCQA will explore the development of consumer-friendly measures of physician and physician group quality. The committee also will convene an expert panel and use surveys and consumer focus groups to determine what information consumers want, when they need it and how they want it to be presented.

CHCF has funded the Physician Group Oversight Improvement Project, a partnership of NCQA, CHCF and the Pacific Business Group on Health, to improve the efficiency of physician group oversight in California. The project's 12-month goal is to reduce the physician groups' cost of oversight through streamlining existing reporting and oversight activities.

Grants go to primary care research

Last month, the U.S. Agency for Healthcare Research and Quality awarded a total of $2 million to 19 primary care research networks. The one-year grants were the first of their kind designated to fund practice-based research networks that focus on primary care.

Over the past several years, clinical research in primary care topics has exploded, said John M. Eisenberg, MD, AHRQ director. The organization operates with a $203 million annual budget; about $166 million of that is used for clinical research at academic and community settings.

"This initiative creates an opportunity for clinicians and researchers to work together to improve the primary care delivered in the United States," Dr. Eisenberg said.

The 19 research centers contract with 5,000 primary care physicians with more than 7 million patients involved in the projects. Each grant will help networks collect and analyze data, study health care of minority and underserved populations and translate research into practice.

Among the networks are: Dartmouth Medical School ($142,970); Indiana University School of Medicine ($134,008); Mount Sinai School of Medicine ($125,650); University of California, San Francisco ($132,750); and the American Academy of Family Physicians ($121,388).

Patient safety research to be funded

The Agency for Healthcare Research and Quality is seeking applications for demonstration research projects that use clinical informatics to promote patient safety. Nonprofit organizations, clinics and universities, as well as state, federal and local government agencies may apply.

AHRQ plans to award up to $3.5 million under its request for applications, the fourth in a series of six to be released in fiscal year 2001 under the agency's new patient safety demonstration program.

The agency will assess how information technology innovations contribute to measurable and sustainable improvements in patient safety and quality of care.

It will consider research in three areas: the role of computers and technology in improving clinical decision-making, reducing errors and advancing patient safety; barriers to acceptance and adoption of health information technology for improved patient safety; and use of effective strategies to improve patient safety while maintaining confidentiality.

AHRQ will give special priority to applications that emphasize outpatient health care settings and priority populations, including women, children, the elderly, minorities, low-income populations and patients with special health care needs.

Applications are due April 23. For more information, contact AHRQ at (301) 594-1364.