In fiscal 2015, 721 hospitals will have their Medicare payments reduced for being among the 25 percent of hospitals with the highest rates of hospital-acquired conditions.
Here are 15 things to know about the HAC program and the hospitals receiving penalties.
1. The HAC Program, created under the Patient Protection and Affordable Care Act, is aimed at reducing preventable harm to patients by penalizing the 25 percent of hospitals with the highest rates of HACs. These facilities will have their payments reduced by 1 percent for all discharges occurring after Oct. 1, 2014.
2. The HAC reduction is made after adjustments are made for the Value-Based Purchasing Program.
3. The penalties for the 721 hospitals total $373 million, according to Kaiser Health News.
4. These penalties aren’t the first hospitals have gotten from Medicare in 2014. Medicare also penalized 2,610 hospitals for high readmission rates this year under the Hospital Readmissions Reduction Program. Those hospitals will receive lower payments for every Medicare patient stay from Oct. 1 to Sept. 30, 2015.
5. The HACs looked at for the program are specified by CMS each year and include a group of reasonably preventable conditions, including infections that patients did not have upon admission and developed during the hospital stay.
6. The HAC program has three measures for FY 2015: Patient Safety Indicator 90 composite, central line-associated bloodstream infections and catheter-associated urinary tract infections.
7. About 1,400 hospitals, such as psychiatry and rehabilitation hospitals, are exempt from HAC program penalties because of the type of treatment they provide. Additionally, critical access hospitals and hospitals in Maryland are exempt.
8. Each hospital in the HAC program receives a score of one to 10 points based on its national ranking, with a lower score being better. For fiscal 2015, the 25 percent of hospitals receiving penalties had total scores above seven.
9. Of the 721 hospitals receiving penalties, more than 90 had a score of nine or higher.
10. There are 143 major teaching hospitals, including Grady Memorial Hospital in Atlanta and Northwestern Memorial Hospital in Chicago, receiving penalties, according to Kaiser Health News.
11. Some renowned hospitals were included on the list of those receiving penalties, including Cleveland Clinic and Geisinger Medical Center in Danville, Pa.
12. Although the government took into account the specific demographics of patients at hospital when judging complications, academic medical centers feel the adjustments are insufficient due to the types of care they provide and the types of cases they handle, according to Kaiser Health News.
13. California has more hospitals than any other state, and it is also home to the most hospitals receiving penalties.
14. No hospitals in Vermont or Hawaii were penalized.
15. On Dec. 18, the American Hospital Association sent a letter to the Director of the Quality Measurement and Health Assessment Group, providing comment on the reevaluation of the HAC program scoring methodology. In it’s letter, the AHA strongly urged CMS “to address other more significant and meaningful issues in the HAC program” going forward, including supporting “innovative approaches to measuring patient safety events” such as hospitals “developing all-cause patient harm measures derived from EHRs.”
