Cash-strapped hospitals made more progress on hospital-acquired infections

Hospitals that have made the most progress reducing hospital-acquired infections (HAIs) are also some of the most financially constrained, according to Medscape MultiSpecialty.

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In the first year of the Centers for Medicare & Medicaid Services' Hospital-Acquired Conditions (HAC) Payment Policy, which penalizes hospitals for HACs, the hospitals with the least amount of resources improved their infection rates the most, according to research presented at the Association for Professionals in Infection Control and Epidemiology 2015 Annual Meeting in Nashville, Tennessee.

Prior research showed no correlation between the CMS policy and HAI rates, leading to concern the policy might be overly punitive to cash-strapped hospitals, a common criticism of other CMS incentive programs such as the Hospital Readmissions Reduction Program.

Researchers Grace Lee, M.D., of Boston Children's Hospital and Harvard Medical School, and Michael Calderwood, M.D., of Brigham and Women's Hospital, analyzed data from the Centers for Disease Control and Prevention's National Healthcare Safety Network. They found that among the 92 hospitals in the lowest quartile for operating margins, the decrease in quarterly HAI rates rose from 3 percent to 8 percent after the policy was implemented, the publication reported. Comparatively, the decrease only increased from 4 percent to 5 percent for hospitals in the highest quartile. All hospitals in the lowest quartile operated at an annual loss of at least 5.78 percent, according to Medscape's conference coverage.

Hospitals in the lowest quartile are largely nonprofits and safety-net providers, which are at greater risk for Medicare penalties, FierceHealthFinance previously reported.

"I think what we are seeing in some cases is that payment incentives and financial penalties may have an effect on where hospitals target their surveillance and infection-control efforts," Linda Greene, R.N., of the Highland Hospital at the University of Rochester in New York, told Medscape. All hospitals, she said, must continue to monitor infection risks specific to their patient population and hospital type.

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