Did the ACA's hospital improvement efforts save 50,000 lives?

What's commonly called "Obamacare" is also known as the Affordable Care Act (ACA), but the full formal title is the Patient Protection and Affordable Care Act, a mouthful that makes it obvious why the shorter names are way more common in practice. But efforts at patient protection are indeed in the act as well as the name. That's one of the reasons the text of the law is so notorious long: There's a lot in there.

In a speech on March 25 (link) President Obama said the law is "a major reason why we’ve seen 50,000 fewer preventable patient deaths in hospitals." That would be a remarkable achievement. It even sounds too good to be true.

But the figure turns out to be a reasonable estimate of lives saved since the law was passed, possibly even an underestimate. Not only that, but it's likely that the reduction in harm also saved $12 billion in health care costs.

U.S. hospitals have long had a problem with preventable illnesses and injuries, and for some time there have been efforts to do something to reduce the numbers of them. The good news is that the statistics have been gradually improving for some time, and the rate of improvement seems to have accelerated thanks at least in part to provisions in the Affordable Care Act.

Both The Washington Post's Fact Checker column (link) and Politifact at the Tampa Bay Times (link) have looked into what Obama said. Their analyses go into some detail about how the figure was arrived at and what it means and what the Affordable Care Act has to do with the changes observed. Politifact reports that independent third parties find the the claim credible:

Lucian Leape, an adjunct professor of health policy at Harvard University’s T.H. Chan School of Public Health, told PolitiFact, "I think these data are reliable, and the ACA (Affordable Care Act) deserves credit."

Leape, who has been studying preventable hospital deaths since the early 1990s, credited improved data collection and the work of Partnership for Patients, "which has been a serious – and successful – effort to engage hospitals in achieving specific goals, such as reducing infections." He said it’s the kind of effort he and others called for a decade and a half ago but "never got before the ACA. Hospitals were improving their safety slowly on their own, and this gave it a big boost. It's the first time we have seen measurable, significant decreases in any of the harms that we cause by treatment failures."

David Nash, dean of the Jefferson School of Population Health in Philadelphia, agreed that the numbers are credible. "This is in part due to a huge amount of work on the part of hospitals," Nash said.

Politifact rated the claim "Mostly True" except for a couple of what it called "fairly minor caveats" (because the president didn't make it clear that the number was an estimate rather than an exact count and neglected to mention that the situation was slowly improving before the ACA took effect).

The Post's Fact Checker normally rates the honesty of a statement with one to four "Pinocchios," with one meaning "Some shading of the facts. Selective telling of the truth. Some omissions and exaggerations, but no outright falsehoods" and four applied to outright "Whoppers." This time they awarded Obama's statement a rare "Geppetto Checkmark," reserved for claims judged to contain "the truth, the whole truth, and nothing but the truth."

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Did the ACA's hospital improvement efforts save 50,000 lives? — 3 Comments

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