The government is cracking down on hospitals with the highest rates of infection and complications by docking Medicare payments. Those hospitals with the worst rates of infections and complications are going to lose 1% of each Medicare payment for one year starting this fall. Federal officials have released a preliminary analysis that identifies 761 hospitals that may be assessed based on poor performance. The estimated sanctions total $330 million over the year, although there may be some changes to assessments before the end of the year. Infections at hospitals are on a decline, but they are still extremely common.
The penalties will hit some types of hospitals especially hard. Penalties are more likely to be imposed on hospitals that are publicly owned or that treat substantial numbers of low-income patients. Major teaching hospitals will likely also be affected.
In calculating a hospital’s infection rates, the government will consider the hospital’s size, location, and affiliation with any medical school. One of the factors that contribute to a high scores were high rate of urinary and bloodstream infections among Medicare patients being treated in intensive care. Another factor is a high rate of surgery-related complications. Certain type of hospitals, such as rehabilitation clinics, children’s hospitals, psychiatric facilities, cancer centers, and critical-access hospitals are exempt from the penalties, as are hospitals with too few patients to be properly evaluated.
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