Patient Safety

Patient Safety Standards

Section 1311(h) of the Affordable Care Act requires QHPs to contract with certain hospitals that use patient safety evaluation systems (PSES) and implement comprehensive hospital discharge programs; and requires QHPs to contract with health care providers who implement health care quality improvement mechanisms.  

CMS finalized implementation of the patient safety standards, for plan years beginning on or after January 1, 2017, to require that a QHP issuer may only contract with a hospital with more than 50 beds if the hospital: (a) works with a Patient Safety Organization; or (b) meets the reasonable exception criteria by implementing an evidence-based initiative to improve health care quality through the collection, management and analysis of patient safety events that reduces all cause preventable harm, prevents hospital readmission, or improves care coordination.

A QHP issuer also has to collect information to demonstrate that these contracted hospitals implement mechanisms for comprehensive person centered hospital discharge to improve care coordination and health care quality for each patient.

Recent Updates

CMS posted the HHS Notice of Benefit and Payment Parameters for 2017 Final Rule in the Federal Register. CMS strengthens QHP issuer patient safety standards to better align with current, effective patient safety interventions, beginning on or after Jan. 1, 2017. The Final Rule can be found at https://www.federalregister.gov/articles/2016/03/08/2016-04439/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2017.