CMS penalties not lowering hospital-acquired condition rates, study finds

Hospitals penalized under CMS' Hospital Acquired Condition Reduction Program do not demonstrate lower hospital-acquired condition rates than their nonpenalized peers, according to a study published in The BMJ.  

For the study, researchers analyzed data on more than 15.4 million Medicare patients who visited 3,238 U.S. hospitals between July 23, 2014, and Nov. 30, 2016. They looked at hospital-acquired conditions per 1,000 episodes, 30-day readmissions and 30-day mortality rates at each hospital.

In fiscal year 2015, 724 hospitals were penalized under the HACRP. Researchers included 708 in their analysis. They found the average hospital-acquired condition rate for penalized facilities was 2.72 per 1,000 episodes, compared to 2.06 for nonpenalized hospitals. The 30-day readmission rates for penalized and nonpenalized hospitals were 14.4 percent and 14 percent, respectively. Both groups had a 9 percent 30-day mortality rate.  

"Penalization was not associated with significant changes in rates of hospital-acquired conditions, 30-day readmission or 30-day mortality, and does not appear to drive meaningful clinical improvements," researchers concluded. "By disproportionately penalizing hospitals caring for more disadvantaged patients, the HACRP could exacerbate inequities in care."

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