Hospitals with the worst rates patient infections have, on average, improved since 2018.
Despite moving the needle on healthcare-associated infections, however, there will always be losers under the CMS Hospital-Acquired Condition Reduction Program. The bottom 25%—749 hospitals—are subject to 1% Medicare payment cuts in fiscal 2022.
The Affordable Care Act established the penalty program as a way to put a spotlight on persistent patient safety problems. But the hospital industry questions whether the system is is fair, especially because healthcare-associated infections were declining prior to the COVID-19 pandemic.
"We've always found that it's misguided to have a program in which 25% of all hospitals must get a penalty based on performance, and it doesn't matter whether that individual hospital is improving," said Akin Demehin, director of policy at the American Hospital Association. "We don't think that's the optimal way to improve care."
A Modern Healthcare analysis shows that only 4.3% of hospitals that submit their infection data every year are consistent offenders that suffered penalties every year since 2018. These hospitals included University Medical Center of El Paso in Texas, Scripps Memorial Hospital Encinitas in California and Ascension St. Francis Hospital in Milwaukee. These hospitals didn't respond to requests for comment.
"That means most hospitals are really trying to improve," said Tejal Gandhi, chief safety and transformation officer at Press Ganey. "They may have a year where they didn't do well for whatever reason, but that there aren't a lot of hospitals consistently in the bottom 25%, I think, is a good thing."
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