It may come as a surprise to many people, but even top hospitals aren’t immune from poor practices. Hospital-acquired infections and injuries are uncommon, but they can occur whenever systems aren’t carefully designed to prevent them.
Recently, the Centers for Medicare & Medicaid Services issued a list of 786 hospitals that it says have higher rates of hospital-acquired conditions than others. They will receive a reduction in payments by 1% for a year under the Affordable Care Act’s “Hospital-Acquired Condition Reduction Program.”
Under the program, Medicare is required to punish the 25% of general care hospitals with the highest rates of preventable hospital-acquired conditions, such as:
- Sepsis cases
- Blood clots
- Hip fractures
- Reactions to medication
The idea is to punish the programs by paying them less, but not by paying them so much less that they cannot survive the penalty.
In the six years of the program, 1,865 of the nation’s 5,276 general care hospitals have received the penalty for at least a year. This year, 145 hospitals were penalized for the first time, according to an analysis by Kaiser Health News. In addition, 16 hospitals that had previously been penalized each year avoided the penalty this year.
Interestingly, of the 21 hospitals on U.S. News’ Best Hospitals Honor Roll, seven received the penalty this year.
One of those, UCSF Medical Center in San Francisco, claims that it was penalized due to their thoroughness in identifying and reporting hospital-acquired conditions. In other words, their rate of infections and injuries only seems higher.
One hospital that had been penalized in the past but escaped penalty this year, Novant Health Presbyterian Medical Center in Charlotte, N.C., claims that it managed to lower its infection rates by focusing on using fewer urinary catheters and central IV lines, as well as by standardizing infection-prevention steps during surgery and improving hand-washing rates.
The Hospital-Acquired Condition Reduction Program doesn’t apply to hospitals that serve children, psychiatric patients or veterans, or those considered critical-access hospitals.
How common are hospital-acquired conditions?
According to the federal Agency for Healthcare Research and Quality, there were approximately 2.5 million hospital-acquired conditions in 2017. The good news is that the agency estimates the rate has been dropping about 4.5% each year since 2014, with large decreases in Clostridioides difficile (C. diff) infections, medication reactions and postoperative blood clots.
If you have been injured in a hospital, developed an infection or experienced another preventable health complication, contact an experienced medical malpractice attorney for an evaluation of your case.