CMS cuts payments to 764 hospitals over patient complications

CMS will trim 764 hospitals' Medicare payments in fiscal year 2022 for having the highest rates of patient injuries and infections, according to Advisory Board

The Hospital-Acquired Conditions Reduction Program aims to prevent harm to patients by providing a financial incentive for hospitals to prevent hospital-acquired conditions. Under the program, a hospital's total score is based on performance on several quality measures, including rates of infections, blood clots and other complications that occur in hospitals and might have been prevented. 

Each year, Medicare cuts payments by 1 percent for hospitals that fall in the worst-performing quartile. The fiscal year 2022 penalties are based on patients who stayed in the hospital between mid-2018 and 2019. CMS excluded 2020 data from the calculations in response to the COVID-19 public health emergency, according to Advisory Board. 

The 764 hospitals will have their Medicare payments reduced for patients discharged in fiscal year 2022. The penalties will be applied as hospitals submit claims for Medicare reimbursement. 

Hawaii and Idaho are the only two states with hospitals included in the HAC Reduction Program where hospitals received no penalties for fiscal year 2022, according to Advisory Board. 

The hospital industry has argued the program's design punishes hospitals that test most thoroughly for infections, since these facilities will appear to have the highest rates of infection, while those with less thorough testing might appear to have lower rates. 

View the full results from CMS here.

Read the full Advisory Board analysis here

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