- The Centers for Medicare & Medicaid Services reduced payments for 751 hospitals in fiscal 2018 due to high rates of hospital-acquired conditions.
- More than half also faced penalties last year, when the 769 hospitals saw their Medicare payments cut. CMS levies the penalties under the Hospital-Acquired Conditions Reduction Program, which was created by the Affordable Care Act.
- Teaching hospitals were again hard hit. One-third face lower payments this year versus half last year. Among the 115 academic medical centers affected this year are Grady Memorial Hospital in Atlanta, Northwestern Memorial Hospital in Chicago and Stanford Health Care hospitals in California, according to a Kaiser Health News analysis.
The federal government examined 3,306 hospitals during the fourth year of the HAC Reduction Program and those in the bottom 25% for patient safety face a one-year, 1% cut in Medicare payments.
This year showed some progress in patient safety. The number of hospitals subject to payment reductions topped out at 751, down from a program high of 769 last year. The number of hospitals subject to reductions in fiscal 2015 and 2016 was 724 and 758, respectively.
Under the program, hospitals are rated based on six quality measures: central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, methicillin-resistant Staphylococcus aureus infections, Clostridium difficile infections and a round-up composite of 10 hospital-related injuries, including post-surgical wound ruptures, sepsis and bed sores.
Of the hospitals penalized this year, 425 had payments cut last year as well. The reductions apply retroactively to Oct. 1, 2017, the beginning of the 2018 fiscal year. Safety net hospitals consistently comprise a large proportion of those punished, since they treat sicker patients and those with more complicated conditions.
On the plus side, 336 hospitals escaped punishment this year after losing payments in fiscal 2017. Among those who improved their safety scores are Brigham and Women’s Hospital in Boston, the Cleveland Clinic and Cedars-Sinai Medical Center in Los Angeles, the KHN analysis shows.
Advocates of the program say it has pushed hospital leaders to focus more squarely on patient safety issues. But critics, including the American Hospital Association, have claimed it unfairly penalizes larger safety net hospitals that treat sicker patients and those with more complicated conditions.