Another concern is there may be little difference in the performance between hospitals that narrowly draw penalties and those that barely escape them. That is because the health law requires Medicare to punish the worst-performing quarter of the nation’s hospitals each year, even if they have been improving.
"Hospitals that have been working hard to reduce infections may end up in the penalty box," said Nancy Foster, vice president for quality and public safety at the American Hospital Association.
Third Leg Of Medicare’s Pay-For-Performance
The Hospital-Acquired Condition (HAC) Reduction Program, created by the 2010 health law, is the third of the federal health law’s major mandatory pay-for-performance programs for hospitals. The first levies penalties against hospitals with high readmission rates and the second awards bonuses or penalties based on two dozen quality measures. Both are in their second year. When all three programs are in place this fall, hospitals will be at risk of losing up to 5.4 percent of their Medicare payments.
In the first year of the HAC penalties, Medicare will look at three measures. One is the frequency of bloodstream infections in patients with catheters inserted into a major vein to deliver antibiotics, nutrients, chemotherapy or other treatments. The second is the rates of infections from catheters inserted into the bladder to drain urine. Both those assessments will be based on infections during 2012 and 2013.
Finally, Medicare will examine a variety of avoidable safety problems in patients that occurred from July 2011 through June 2013, including bedsores, hip fractures, blood clots and accidental lung punctures. Over the next few years, Medicare will also factor in surgical site infections and infection rates from two germs that are resistant to antibiotic treatments: Clostridium difficile, known as C. diff, and Methicillin-resistant Staphylococcus aureus, known as MRSA.
Vidant is worse than average in catheter-associated urinary tract infections and serious complications from surgery in the latest statistics Medicare published on its Hospital Compare website. But in more recent data the medical center voluntarily reports on its website, the number of catheter and urinary tract infections dropped during 2013. Joan Wynn, Vidant Health’s chief quality and safety officer, said complications rates are dropping this year as well.
Fri, Jun 20 2014