Medicare penalties for hospital-acquired infections didn't cut infection rate, study finds

The research, reported in the New England Journal of Medicine, looked at the effect of a 2008 change that cut payments to hospitals for treating infections that patients received while hospitalized.

The Wall Street Journal: Medicare Shift Fails To Cut Hospital Infections
A high-profile Medicare policy that sought to reduce certain hospital-acquired infections by cutting payments tied to treating them turned out to have no impact, according to a new study in the New England Journal of Medicine. The study, which looked at the effect of the 2008 payment change on bloodstream and urinary-tract infections related to catheters, found "no evidence" that the shift had any measurable impact on the infections, which were already decreasing before the change went into effect. The study follows other research that has cast doubt on the effectiveness of some efforts to tie reimbursement to quality-improvement efforts in health care, an approach that is being considerably ramped up under the federal health overhaul (Mathews, 10/10).

Kaiser Health News: Study: CMS Penalties Don't Change Hospital-Acquired Infection Rates
A Medicare payment policy designed to push hospitals to cut their infection rates has had no effect in reducing two types of preventable infections among patients in intensive care units, researchers say in a study out Wednesday in the New England Journal of Medicine (Appleby, 10/10).

Medscape: Preventable Hospital Infections Not Reduced By Disincentives
The Centers for Medicare and Medicaid Services (CMS) 2008 policy to discontinue payments for certain preventable hospital infections had no measurable effect on the rates of those infections, according to an assessment of data from 398 US hospitals and health systems (Tucker, 10/10).

Modern Healthcare: Nonpayment Policy Not Impacting Infection Rates: Study
In October 2008, the CMS stopped reimbursing hospitals for 12 hospital-acquired conditions, including patient falls, late-stage pressure ulcers, air embolisms and certain health care-associated infections. Using data gathered before and after the CMS' policy change, researchers found no evidence that nonpayment had lowered rates of central line-associated bloodstream infections or catheter-associated urinary tract infections. Rates of such infections were on a downward trend throughout the study period, the authors said, but those drops could not be attributed to the federal government's hospital-acquired conditions program (McKinney, 10/10).

Medpage Today: No-Pay Policy For In-Hospital Infection Fails
(There) had already been notable decreases in hospital-acquired infections before the financial disincentive program, possibly resulting from efforts by the government, accreditors, and quality improvement organizations to minimize these preventable events, according to the researchers. ... When it became apparent that the "pay for performance" approach of increasing payments when hospitals meet quality goals was having little effect, Congress directed CMS to begin using a more punitive approach, withholding payments for adverse outcomes (Walsh, 10/10).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


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