By Yoku Shaw-Taylor, PhD
Against the backdrop of increasing rates of physician burnout, the Department of Health and Human Services (HHS) announced a major project in October 2014 to recruit 140,000 clinicians or healthcare providers for a “transformative” initiative to enhance the quality of care and reduce its costs. Physicians are the primary target of the recruitment efforts. This initiative is a gamble because the factors that reportedly contribute to physician burnout are the same requirements that physicians would have to meet under this new program.
Over a four-year period (2015 to 2019), HHS will commit $840 million to build on the Hospital Engagement Networks program, or HEN, and the campaign to engage patients and families called Partnership for Patients, or PfP.
The problem of attribution
Of the 11 areas targeted for reducing patient harm, only five have shown clear evidence of significant reductions due to the HEN program (Health Services Advisory Group & Mathematica Policy Research, 2014). Within the same period of HEN implementation, evaluators identified cost savings in health outcomes of between $3 billion and $4 billion and an estimated 15,500 deaths averted. However, it is difficult to attribute these benefits to the HEN program alone; the evaluators reported that “it is not possible at this time for the evaluation to identify the portion of these harm reductions and savings attributable to the PfP campaign’s direct work with hospitals” (Health Services Advisory Group & Mathematica Policy Research, 2014).
The Agency for Healthcare Research and Quality (2015) also reported that there was a 17% decline in hospital-acquired conditions from 2010 to 2014, “although the precise causes of the decline in patient harm are not fully understood.”
The ambitious project, called the Transforming Clinical Practice Initiative (TCPI), has two components: (1) the Practice Transformation Networks, or PTNs, which are “peer-based learning networks designed to coach, mentor and assist clinicians in developing core competencies specific to practice transformation,” and (2) the Support and Alignment Networks, or SANs, which are entities that provide “a system of workforce development [to] … help ensure sustainability [and] … support the recruitment of clinician practices serving small, rural and medically underserved communities” (Centers for Medicare and Medicaid Services, 2016).