Nearly 800 hospitals receive penalties for poor hospital-acquired condition scores

The Centers for Medicare & Medicaid Services will levy a 1 percent reimbursement penalty against nearly 800 hospitals due to poor performance on hospital-acquired conditions (HACs), the agency announced.

Of the 3,308 U.S. hospitals subject to Medicare's HAC program this year, 758 received the penalty compared to 724 last year. Only about half of the penalized providers were subject to the same penalty last year. The facilities in question stand to lose about $364 million in reimbursements.

However, the agency said hospital scores improved for central-line infections, but dropped for catheter-related urinary tract infections. CMS has also added new quality information to its Hospital Compare site, adding data on group practices and accountable care organizations, the agency said, as well as its first set of performance measures for individual practitioners on patient safety, cardiovascular care and patient safety.

The penalties are some of the toughest levied by the federal government in its post-Affordable Care Act push to drive improved healthcare outcomes, an effort that also involves penalizing providers for excessive preventable readmissions.

The CMS program has not been without controversy; a study published in June suggested the most frequently penalized facilities offer high-quality care, indicating the outcomes may simply be the results of hospitals that search more diligently for HACs being likely to find more, FierceHealthcare previously reported.

Indeed, numerous prestigious institutions are subject to penalties in the latest round of penalties, according to Kaiser Health News, including Stanford Health Care and two satellite facilities run by the Mayo Clinic. Meanwhile, hospitals in tighter financial straits have been among those making the most progress on HAC reduction.

Moreover, the penalties are tough enough to actively hinder providers' attempts to fix the problems, according to Mark Jarrett, M.D., chief quality officer for the North Shore-LIJ Health System, which had several hospitals penalized this year. "What bothers me the most is when people are improving and get that penalty, that's money that could be invested into better care," Jarrett told Kaiser Health News. "Taking the money away, all you've done is to make it harder for hospitals to function."

To learn more:
- here's the CMS announcement
- read the CMS fact sheet
- read the KHN article

 

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