Innovations
from the Field:
Implementing Quality Improvement
UnderThe New Medicare Prescription Drug Benefit
This
conference brings together health care experts and government officials
to discuss how to best implement an important provision of the new Medicare
drug benefit law—the improvement of prescription drug treatment
for Medicare beneficiaries.
The two-day
conference in Washington features presentations by:
- CMS Administrator
Mark McClellan (invited)
- Agency
for Healthcare Research and Quality Director Carolyn Clancy
- House
Health Subcommittee Chairwoman Rep. Nancy Johnson (invited)
- Nationally-known
researchers, drug plan administrators, quality improvement leaders,
and prescription treatment experts.
| The
Conference will be held May11th and 12th
in downtown Washington. |
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The
conference will explore a new opportunity to address major drug quality
issues facing the elderly.
The Medicare
Modernization Act (MMA) of 2003 specifically directs Quality Improvement
Organizations (QIOs) to help providers, practitioners, Medicare Advantage
and prescription drug plans provide beneficiaries with more effective
prescription drug therapy.
What’s
At Stake
Numerous
research studies report widespread misuse and overuse of prescription
drugs leading to often avoidable, potentially serious adverse drug events.
For example:
- A recent
JAMA study estimates that more than 1,900,000 adverse drug events—more
than a quarter of which are preventable—occur each year among
Medicare enrollees. The authors estimate that among these there are
more than 180,000 life threatening or fatal adverse drug events per
year, of which more than half may be preventable. (Gurwitz et al, JAMA
2000;109: 87-94.)
- Studies
show that annual estimates of outpatients experiencing adverse drug
events range from 5% to 35%.
- Respondents
to a survey given recently to outpatients at four Boston primary care
clinics reported that 25% had experienced adverse drug events during
a four week period. More than 10% of these were serious. ( NEJM 348;16
April 17, 2003.)
- The cost
of adverse drug events is substantial. One recent study shows that 6.3%
of all malpractice claims filed with a New England insurance company
during the 1990’s represented adverse drug event claims. (Arch
Intern Med/Vol 162, November 25, 2002)
Numerous
studies have also shown that under use of prescription drugs on an outpatient
basis has a serious negative impact on the treatment of chronic disease
among Medicare beneficiaries. For example, patients often leave the hospital
without being prescribed recommended drugs for the treatment of heart
disease. In addition, many patients often fail to fill prescriptions or
to take medications according to directions.
What
can be done?
The conference
will look at potential solutions such as the use of claims data and information
technology to improve patient safety and increase the effectiveness of
drug treatment.
It will also
look closely at the framework established by the new drug benefit law
for improving drug therapy for America’s seniors
It will explore
how Medicare (CMS) and Quality Improvement Organizations can work with
partners to make the most of this opportunity.
AHQA
represents the national network of Quality Improvement Organizations. |
