Medicare penalizes 800 hospitals with highest rates of hospital-acquired infections, injuries; here's a link to a list

Medicare will pay 800 hospitals less this year because of high rates of patient infections and injuries. That's the highest number since the government established the Hospital Acquired Conditions Reduction Program five years ago under the 2010 Patient Protection and Affordable Care Act. In the past five years, 1,756 hospitals have been punished at least once, and 110 are being penalized for the fifth straight year, Jordan Rau reports for Kaiser Health News. Click here to see if your local hospital is on the list.

"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," Rau reports. "Each year, the quarter of general hospitals with the highest rates are punished, even if their records have improved from the previous year." Critical-access hospitals and specialty hospitals like those for veterans, psychiatric patients, or children are excluded from consideration.

The hospital industry argues that the program creates an arbitrary cut-off for penalties. The American Hospital Association, a lobbying group, calculated that about 59 percent of the 768 hospitals punished in 2017 had HAC scores that were barely worse than hospitals not punished. "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," Rau reports. However, the program's supporters argue that the threat of losing money motivates hospitals to improve.

Has the program helped decrease hospital-acquired conditions? Mostly: a June report by the federal Agency for Healthcare Research and Quality found an 8 percent decrease in such conditions from 2014 to 2016, but also found an increase in bedsores and urinary tract infections in catheterized patients during that time. The HACRP program bases its penalties on some of the conditions examined in the AHRQ report, Rau reports.