CMS cuts payments to 786 hospitals over high rates of infection, injury

CMS will trim 786 hospitals' Medicare payments in fiscal year 2020 for having the highest rates of patient injuries and infections.

Five things to know:

1. Created under the ACA, 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 six quality measures. Each year, Medicare cuts payments by 1 percent for hospitals that fall in the worst-performing quartile.

2. On Jan. 29, CMS identified the 786 hospitals that will have their Medicare payments reduced for patients discharged between last October and this September, according to Kaiser Health News. The penalties will be applied as hospitals submit claims to Medicare for reimbursement.

3. According to KHN, Medicare is penalizing the following seven hospitals named to U.S. News' Best Hospitals Honor Roll:

  • UPMC Shadyside (Pittsburgh)
  • Ronald Reagan UCLA Medical Center (Los Angeles)
  • Keck Hospital of USC (Los Angeles)
  • Stanford (Calif.) Hospital
  • UCSF Medical Center (San Francisco)
  • NewYork-Presbyterian Hospital (New York City)
  • Mayo Clinic (Phoenix)

4. The Hospital-Acquired Conditions Reduction Program is in its sixth year. Sixteen hospitals across the U.S. have been penalized all six years, according to KHN.

5. The hospital industry has argued the program's design causes hospitals that do the best job of testing for infections to appear among the worst based on statistics, while those with less thorough testing might appear better than they should.

Access the full Kaiser Health News article here



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