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Medicare Sweep Penalizes Hospitals for Patient Infections

Nationwide, Hospitals Face Medicare Penalties for Patient Infection Rates

patient infectionThe Hospital-Acquired Condition Reduction Program was created in 2010 by federal health care reform laws and has helped reduce patient infections and other complications across the country. However, as part of the program, Medicare is gearing up in October to reduce payments to hospitals that have the worst rates of patient infection.

The laws were enacted in 2010 and did reduce patient infection and complication rates, but in 2012, 1 out of every 8 patients nationally suffered an avoidable complication or infection during a hospital stay. As more and more “superbugs” like MRSA spread, Medicare officials and other federal regulators believe it is more important than ever to crack down on hospital complications.

Dr. Clifford McDonald, a senior adviser at the federal Centers for Disease Control and Prevention, says the worst performers “still have a lot of room to move in a positive direction.”

In April, Medicare officials released a preliminary analysis of hospitals that need close assessment, and found 761 hospitals across the United States that have serious problems with patient infection rates.

Starting in October of this year, hospitals across the country with the worst rates of patient infections will lose 1% of every Medicare payment for a year. The Hospital-Acquired Condition Reduction Program is the third of three major health care and performance reforms introduced, and by October, all three will be fully in place. The first of the programs levies penalties against hospitals for high readmission rates, and the second creates two dozen quality measures and either awards or penalizes hospitals for meeting those qualifications.

With all three programs in place in October, the worst offenders stand to lose 5.4% of their Medicare payments.

In the first year of the program, Medicare will look at patient infections in three area: bloodstream infections from intravenous treatments like chemotherapy, nutrients, or antibiotics; bladder infections from catheters; and avoidable infections from bedsores, hip fractures, blood clots, or accidental lung punctures.

Over the next several years, Medicare will look at other avoidable hospital problems such as infections from surgical wounds, as well as patient infections from one of two antibiotic resistant bacteria: Clostridium difficile, known as C. diff, and methicillin-resistant Staphylococcus aureus, known as MRSA.

“We want hospitals focused on patient safety and we want them laser-focused on eliminating patient harm,” says Dr. Patrick Conway, chief medical officer of the Centers for Medicare & Medicaid Services.

Medicare’s programs could hit some hospitals harder than others, according to an analysis from Kaiser Health News. According lead researcher Dr. Ashish Jha, publically-owned hospitals with high proportions of low-income patients, especially those in high-density urban areas, could be hit the hardest, because a large portion of their income comes from federal money in Medicare and Medicaid.

“With infections, we are moving in the right direction,” says Lisa McGiffert, who directs the patient safety program at Consumers Union. “But I would not say we are anywhere near where we need to be.”

The Strom Law Firm Can Help Those Suffering from Infection or Complications from Hospital Error

Each year, nearly 100,000 people die as a result of surgical errors, and many more suffer devastating personal consequences. Surgical errors and medical malpractice can ruin you and your loved ones’ lives, demanding time away from work and thousands of dollars in medical bills. If you or a loved one has suffered pain, patient infection, and continuing health problems after surgery, you may be entitled to compensation for your injuries. The attorneys at the Strom Law Firm can help. We offer free consultations, so contact us today about your medical malpractice concerns. 803.252.4800.



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