Dive Brief:
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A new study published in JAMA suggests that a CMS program that lowers payments to hospitals that fail to reduce hospital-acquired conditions may be unfairly penalizing hospitals.
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The hospitals that were penalized most frequently were major teaching institutions that actually scored higher on the study's quality summary score. Those institutions often have more accreditations and advanced services and better performance on process and outcome measures.
- "These findings suggest that penalization in this program may not reflect poor quality of care but rather may be due to measurement and validity issues of the HAC program component measures," according to the authors.
Dive Insight:
The researchers suggest the HAC Reduction Program may be experiencing surveillance bias, in which hospitals that are better at identifying adverse events could incorrectly appear to have more of them. Differences in information technology could also be a factor in detecting adverse events, researchers also note.
Other researchers have suggested that hospitals with fewer resources have fared better because they were able to make a bigger impact on their rate of HACs and have more incentive to do so.
CMS says its methodology for the program was approved by the National Quality Forum, reports Scripps News. It adds that CMS penalized 721 hospitals of the 3284 participating by withholding 1% of their Medicare reimbursement.