Four potentially avoidable complication (PAC) measures from the Health Care Incentives Improvement Institute Inc. (HCI3) have been endorsed by the National Quality Forum (NQF), a quality improvement and consensus standards setting organization. Reduction of PACs – preventable failures in care that cause harm to patients–can play an important role in U.S. reform efforts to move health care away from fragmentation, poor performance and dysfunction toward accountability for high-value care.
HCI3's PACs are already incorporated in PROMETHEUS Payment, the organization's model for health care measurement and payment that rewards hospitals and physicians for coordinating and providing high-quality care. The NQF-endorsed PACs cover acute myocardial infarction (heart attack), pneumonia, stroke and six chronic conditions: diabetes, congestive heart failure (CHF), hypertension, chronic obstructive pulmonary disease (COPD), asthma and coronary artery disease (CAD).
HCI3's analysis of national claims data of more than 3.5 million commercially insured members under the age of 65 found that PACs account for up to 30 cents of every dollar in U.S. health care spending across six common chronic conditions: asthma, CAD, CHF, COPD, diabetes and hypertension. The analyses also shows wide variation in PAC costs between providers and across the country, suggesting that these costs can, in fact, be reduced. (1,2)