Hospitals participate in CMS "pay-for-reporting" program

Hospitals That Report Patient Infection Rates Will Receive Higher Medicare Payments

Beginning next year, consumers across the country will be able to find out how their hospital stacks up when it comes to preventing certain infections under new hospital acquired infection reporting regulations adopted by the Department of Health & Human Services (HHS).  

The new reporting requirements apply to hospitals that participate in the Centers for Medicare and Medicaid Services (CMS) "pay-for-reporting" program.   Virtually all hospitals in the country participate because they earn a higher Medicare payment for doing so.  Beginning in October 2012, Medicare payments to hospitals will be tied to how well they protect patients from these infections and perform on other patient safety standards.

Public reporting of infection rates will ultimately help to save countless lives and dollars by putting pressure on hospitals to work harder to improve prevention efforts, according to Consumers Union, the nonprofit publisher of Consumer Reports.

"Patients shouldn't have to worry about getting sicker with an infection they catch in the hospital but every year nearly two million Americans do," said Lisa McGiffert, Director of Consumers Union's Safe Patient Project (www.SafePatientProject.org).  "Making infection rates public is a powerful motivator for hospitals to improve care and keep patients safe.  This is an enormous victory for patient safety advocates who have worked tirelessly to hold hospitals accountable for failing to eliminate infections."

The HHS regulations are being issued under the landmark health care reform law adopted earlier this year and were developed as part of the Department's five-year action plan to reduce hospital acquired infections, which are associated with nearly 100,000 deaths annually.  The Centers for Disease Control & Prevention (CDC) estimates that the direct costs associated with hospital infections are as high as $45 billion each year.

Starting in January 2011, hospitals will be required to report to the CDC the rates that patients develop central line associated bloodstream infections (CLABSI) in the intensive care and neonatal intensive care units.  The CDC estimates that patients develop more than 250,000 central line associated bloodstream infections each year while in the hospital.  

Infection rate information for each hospital will be posted later that year on the federal Hospital Compare web site.  During the first year of public reporting, Medicare payments will be tied to hospitals for reporting infection rates, but following that first year, the payments will be tied to meeting a certain standard for infection rates.

Hospitals will be required to begin reporting surgical site infection rates to the CDC in January 2012 and that information will be posted on Hospital Compare every quarter.  According to the CDC, more than 290,000 surgical site infections occur in U.S. hospitals each year, affecting patients in two out of every 100 surgeries.