![]() ![]() In a statement, CMS noted it had limited ability to alter the program. Subscribe to KFF Health News' free Morning Briefing.Īnother issue raised by researchers and the hospital industry is that under the law, the Centers for Medicare & Medicaid Services each year must punish the quarter of general care hospitals with the highest rates of patient safety issues even if they have improved and even if their infection and complication rates are only infinitesimally different from those of some non-penalized hospitals. Academic medical centers say the reason nearly half of them are penalized each year is that they are more diligent in finding and reporting infections. One problem, he added, is “you’re kind of asking hospitals to call out events that are going to have them lose money, so the incentives are really messed up for hospitals to fully disclose” patient injuries. “It’s very hard to capture patient safety with the surveillance methods we currently have,” he said. “Unfortunately, pretty much in every regard, the program has been a failure,” said Andrew Ryan, a professor of health care management at the University of Michigan’s School of Public Health, who has published extensively on the program. But researchers have found little evidence that the penalties are getting hospitals to improve their efforts to avert bedsores, falls, infections, and other accidents. ![]() Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.Įight years into the Hospital-Acquired Condition Reduction Program, 2,046 hospitals have been penalized at least once, a KHN analysis shows. This year’s list of penalized hospitals includes Cedars-Sinai Medical Center in Los Angeles Northwestern Memorial Hospital in Chicago a Cleveland Clinic hospital in Avon, Ohio a Mayo Clinic hospital in Red Wing, Minnesota and a Mayo hospital in Phoenix. Those include surgical infections, urinary tract infections from catheters, and antibiotic-resistant germs like MRSA. The punishments, which the Affordable Care Act requires be assessed on the worst-performing 25% of general hospitals each year, are intended to make hospitals focus on reducing bedsores, hip fractures, blood clots, and the cohort of infections that before covid-19 were the biggest scourges in hospitals. The penalties - a 1% reduction in Medicare payments over 12 months - are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. Here are links to articles and data since 2015. You can filter by location, hospital name or year. This was modified by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act of 2010, which provided that beginning in fiscal year (FY) 2015, the reduction would be by one-quarter of such applicable annual payment rate update if all Hospital Inpatient Quality Reporting Program requirements are not met.Īdditional information on the Hospital Inpatient Quality Reporting Program can be found at the links listed below.Here are the hospitals hit with safety penalties for 2022. ![]() The Deficit Reduction Act of 2005 increased that reduction to 2.0 percentage points. Initially, the MMA provided for a 0.4 percentage point reduction in the annual market basket (the measure of inflation in costs of goods and services used by hospitals in treating Medicare patients) update for hospitals that did not successfully report. This section of the MMA authorized CMS to pay hospitals that successfully report designated quality measures a higher annual update to their payment rates. The Hospital Inpatient Quality Reporting Program was originally mandated by Section 501(b) of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. Data for selected measures are also used for paying a portion of hospitals based on the quality and efficiency of care, including the Hospital Value-Based Purchasing Program, Hospital-Acquired Condition Reduction Program, and Hospital Readmissions Reduction Program. The data collected through the program are available to consumers and providers on the Care Compare website at. It is also intended to encourage hospitals and clinicians to improve the quality and cost of inpatient care provided to all patients. Under the Hospital Inpatient Quality Reporting Program, CMS collects quality data from hospitals paid under the Inpatient Prospective Payment System, with the goal of driving quality improvement through measurement and transparency by publicly displaying data to help consumers make more informed decisions about their health care. ![]()
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