Hospitals Lagging on PSO Contracts

Cheryl Clark, for HealthLeaders Media , June 6, 2013

Laurie Cohen, a partner in the health practice group for the law firm, Nixon Peabody LLP in New York City, says that in her conversations with providers, "plenty of health plans…are unaware of this requirement. This is not on the front burner for them.

"I'm waiting to see if health plans, at some point, will think that this provision will interrupt their network adequacy." It may be, she says, that an insurance company contracts with a hospital to provide services to Medicare Advantage, regular Medicare beneficiaries, and commercially-insured enrollees "but will have to disassociate with that hospital" in exchange plan offerings.

Officials with Americas Health Insurance Plans declined comment.

However, some approved patient-safety organizations are trying to get out the word. One of the oldest, the national ECRI Institute, sent out this e-mail recently in an effort to recruit hospitals:

"The Challenge: The Affordable Care Act has Patient Safety Organization(PSO) requirements. Starting January 1, 2015, a hospital with 50+ beds can only participate in a Health Insurance Marketplace (aka health insurance exchanges) if the hospital has a Patient Safety Evaluation System (PSES) in place.

"The Solution: The time is now for PSO participation—the deadline is looming. Although 2015 may seem a ways off, it is not. ECRI Institute PSO can help you establish your Patient Safety Evaluation System."

ECRI's Executive VP and General Counsel, Ronni P. Solomon, said the organization "is thoroughly prepared" with a scalable program to accommodate large numbers of organizations.

"In fact, the more the merrier, because that means more data to share and learn."

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2 comments on "Hospitals Lagging on PSO Contracts"

Jim (6/12/2013 at 11:20 AM)
One major hurdle is CMS insistence that they be allowed to view data that a provider could make PSWP under the PSQIA. The PSQIA clearly states that incident reports and RCAs can be PSWP. PSWP cannot be shared with regulating agencies such as CMS but CMS demands these documents. They have stated that participation with CMS is voluntary but really? In today's environment is not accepting Medicare/Medicaid patients viable for any large hospital?

Becky Miller (6/6/2013 at 6:24 PM)
Glad to see this article raising national awareness about this obscure ACA provision. While the Center for Patient Safety's 140+ hospital participants have been hearing this from us for some time and are prepared, many hospitals will be caught offguard.PSO participation takes education and policy evaluation that need careful consideration and time; time well worth it for providers to be able to work together to share causes of error in healthcare and continually learn how to prevent harm!




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