721 Hospitals Penalized for Hospital-Acquired Condition Rate
14 percent of hospitals are penalized $373M by CMS because of unacceptable rates of Hospital-Acquired Condition.
- A report was released at the beginning of the month by the Department of Health and Human Services that covered the reduction in hospital-acquired conditions (HAC) from 2010 through 2013. In total, 1.3 million few patients were harmed, 50,000 few patients died and an estimated $12 billion in health costs were saved.
While these are certainly positive numbers, Health and Human Services Secretary Sylvia Burwell called it “a big deal, but its only a start.”
Much of the decline in number of reasonably preventable conditions can be attributed to provisions of the Affordable Care Act which has put a focus on the value of care while also penalizing hospitals that have a high rate of HACs. According to data released last week from the HAC Program, 721 hospitals will be penalized by the federal government because of their rate in HACs. The offending hospitals will have their Medicare payments reduced by 1 percent over the fiscal year that runs from October 2014 through September 2015.
Medicare evaluated three different types of HACs. The first is central-line associated bloodstream infections, the second is catheter-associated urinary tract infections and the final one is serious complications based around eight types of injuries including blood clots, bed sores and falls.
To determine hospital performance under the HAC Reduction program, CMS calculates the a total score for each hospital. The higher the score the less well the hospital performed.
Kaiser Health News estimates that this means roughly one out of every seven hospitals in the nation will be penalized. This will result in an estimated $373 million in lost costs. Academic Medical Centers were hit especially hard as nearly half of them will receive a penalty.
“The new penalties are harsher than any prior government effort to reduce patient harm. Since 2008, Medicare has refused to pay hospitals for the cost of treating patients who suffer avoidable complications,” the article reads. “Legally, Medicare can expel a hospital with high rates of errors from its program, but that punishment is almost never done, as it is a financial death sentence for most hospitals. Some states issue their own penalties — California, for instance, levies fines as high as $100,000 per incident on hospitals that are repeat offenders.”
There is some push back to the fines from hospitals and doctors. Dr. John Bulger, the chief quality officer at Geisinger Health Systems, told WEMU that hospitals now need to spend more time reviewing billing records than the government. to ensure patient safety. This will divert time and resources that should be used on improvement to instead focus on accurate coding.
Nancy Foster, a quality expert at the American Hospital Association, added that there is also confusion around the parameters of the penalties. There are almost no difference between hospitals that are penalized and those that just eek by.
“Hospitals may be penalized on things they are getting safer on, and that sends a fairly mixed message,” Foster said.
This is the second round of big penalties that was announced last week. It was reported that the Centers for Medicare and Medicaid Services has penalized 257,000 eligible professionals for failing to meet meaningful use standards. These practices will see their Medicare payments reduced by 1 percent starting in 2015.
