OAJ Blogs


Posted on: Mar 31, 2020

Seven of the nation’s top-rated hospitals will be punished this year after the government said that they are among hundreds of health care systems with higher infection and patient injury rates.

The Centers for Medicare & Medicaid Services identified 786 hospitals penalized under the Hospital-Acquired Conditions Reduction Program, which was created by the Affordable Care Act.

Program targets hospitals with the highest rates of infection

Each year, 25% of all general care hospitals are hit with the punishments, also called HAC penalties, after the government assesses patient safety issues, such as:

  • Infection rates
  • Sepsis cases
  • Bedsores
  • Blood clots
  • Hip fractures
  • Other complications

Honor roll hospitals are penalized

Kaiser Health News says since the program began, 1,865 of the nation’s 5,276 hospitals have been targeted at least once. The latest announcement included seven of U.S. News’ Best Hospital Honor Roll facilities, including:

  • Ronald Reagan UCLA Medical Center in Los Angeles
  • Keck Hospital of USC in Los Angeles
  • Stanford Health Care’s main hospital in Northern California
  • UPMC Shadyside in Pittsburgh
  • UCSF Medical Center in San Francisco
  • NewYork-Presbyterian/Weill Cornell Medical Center in Manhattan
  • Mayo Clinic in Phoenix

Effectiveness of penalties debated

Under the program, Medicare reduces every payment made to the affected hospitals by 1% during the federal fiscal year, which runs October to September. Critics say the penalty is too low and does not provide enough incentive for hospitals to make dramatic improvements to care.

However, others say the program is designed to encourage better practices without denying Medicare and Medicaid reimbursements to hospitals, which would effectively drive many health care facilities out of business.

Hospital-acquired conditions remain a significant concern

The Agency for Healthcare Research and Quality estimates there were roughly 2.5 million hospital-acquired conditions in 2017. While the agency says rates have been dropping by approximately 4.5% since 2014, it’s unclear whether the penalties have led to the improvement. This year, 145 hospitals received HAC penalties for the first time, while 16 hospitals have been penalized every year since the program began.

Shared by McKeen & Associates, PC
www.mckeenassociates.com/blog

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