Hospital-acquired condition penalty has little effect on reimbursement, study finds

CMS' policy that penalizes hospitals for hospital-acquired conditions has had minimal effect on hospital reimbursement, a study published in Infection Control & Hospital Epidemiology found.

In 2008, CMS stopped reimbursing for hospital-acquired conditions not present on admission. To understand why this policy did not affect central line-associated bloodstream infections and catheter-associated urinary tract infection trends, the researchers analyzed billing practices before and after the policy was implemented.

During the study period (2007-11), the researchers looked at more than 65 million Medicare hospitalizations.

The researchers found after CMS' policy change, the number of infections coded as present on arrival increased, while the number coded as not present on arrival decreased.

It is unclear whether these codes are being used incorrectly or if there's more of an effort now to document issues upon a patient's admission, the study authors said.

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