In its toughest crackdown yet on medical errors, the federal government is cutting payments to 721 hospitals for having high rates of infections and other patient injuries, records released Thursday show.
One out of every 7 hospitals in the nation will have Medicare payments lowered by 1 percent over the fiscal year that began Oct. 1 and continues through September 2015. The health law mandates the reductions for the quarter of hospitals that Medicare assessed as having the highest rates of hospital-acquired conditions, or HACs. These conditions include infections from catheters, blood clots, bed sores and other complications that are considered avoidable.
Charlotte-area hospitals that will be affected: Novant Health Presbyterian Medical Center in Charlotte; CaroMont Regional Medical Center, Gastonia; Cleveland Regional Medical Center, Shelby; and Chester Regional Medical Center, Chester, S.C.
The penalties come as the hospital industry is showing some success in reducing avoidable errors. A recent federal report found the frequency of mistakes dropped by 17 percent between 2010 and 2013, an improvement U.S. Health and Human Services Secretary Sylvia Burwell called “a big deal, but it’s only a start.” Even with the reduction, 1 in 8 hospital admissions in 2013 included a patient injury, according to a federal report.
The new penalties are harsher than any prior government effort to reduce patient harm.
Hospitals complain that the new penalties are arbitrary, since there may be almost no difference between hospitals that are penalized and those that narrowly escape falling into the worst quarter.
“Hospitals may be penalized on things they are getting safer on, and that sends a fairly mixed message,” said Nancy Foster, a quality expert at the American Hospital Association.
The penalties come on top of other financial incentives Medicare has been placing on hospitals. This year, Medicare has already fined 2,610 hospitals for having too many patients return within a month of discharge. This is the third year those readmission penalties have been assessed. This is also the third year Medicare gave bonuses and penalties based on a variety of quality measures, including death rates and patient appraisals of their care. With the HAC penalties now in place, the worst-performing hospitals this year risk losing more than 5 percent of their regular Medicare reimbursements.
In determining the HAC penalties, Medicare judged hospitals on three measures: the frequency of central-line bloodstream infections caused by tubes used to pump fluids or medicine into veins, infections from tubes placed in bladders to remove urine, and rates of eight kinds of serious complications that occurred in hospitals, including collapsed lungs, surgical cuts, tears and reopened wounds and broken hips. Medicare tallied that and gave each hospital a score on a 10-point scale. Those in the top quarter – with a total score above 7 – were penalized. Staff writer Karen Garloch contributed.