Eight hundred hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries
Penalties against hospitals due to safety incidents are the highest since the federal government five years ago launched the Hospital Acquired Conditions (HAC) Reduction Program, created by the Affordable Care Act. Under the program, 1,756 hospitals have been penalized at least once, Jordan Rau reported for Kaiser Health News. This year, 110 hospitals are being punished for the fifth straight time.
The penalties pit hospitals against one another in a race to prevent the most infections, blood clots, cases of sepsis, bedsores, hip fractures and other complications. Each year, the quarter of general hospitals with the highest rates are punished, even if their records have improved from the previous year.
Under the latest round of sanctions, each hospital will lose 1 percent of its Medicare payments for patients discharged between last October and this September. That comes on top of other penalties created by the health care law, such as annual payment reductions for hospitals with too many patients being readmitted.
The hospital industry has protested the HAC penalties, saying the program’s design creates an arbitrary cutoff for which institutions get punished and which don’t. The American Hospital Association calculated that only about 41 percent of the 768 hospitals penalized in 2017 had HAC scores that were statistically significantly higher than hospitals not being penalized.
“There are not statistical differences that would warrant a quarter of the hospitals in America getting a penalty,” said Nancy Foster, the association’s vice president for quality and patient safety.
Hospitals also complain that the ones that do the best job testing for infections and other threats to patients appear to be among the worst based on statistics, while their more lackadaisical peers look better than they might be.
Supporters of the punishments argue that the penalties are warranted in prodding hospitals to improve quality. The threat of losing money elevates the issue in many hospitals to the attention of directors and owners, said Missy Danforth, the vice president of healthcare ratings at the Leapfrog Group, a nonprofit devoted to patient safety.
“The fact that everyone’s talking about it, from front-line nurses to boards of directors, is positioning patient safety where it should be, which is at the forefront of everyone’s minds,” Danforth said.
