The federal government has penalized 769 U.S. hospitals who had high rates of patient injuries and other hospital-acquired conditions such as the spread of antibiotic-resistant bacteria, according to NPR.
The penalties are based on the percentage of avoidable complications that patients are experiencing in the hospitals, such as bed sores, blood clots, falls and certain infections. The Centers for Medicare and Medicaid Services determined the penalties based on which hospitals have the highest rates of these complications.
This year was the first year that hospitalized were also penalized for the spread of antibiotic-resistant bacteria “superbugs” methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile or C. diff). The Agency for Healthcare Research and Quality estimates there were 6,300 cases of infections from MRSA last year, and the agency reported C. difficile was found in 100,000 cases last year.
The Hospital-Acquired Condition Reduction Program, which is run by the U.S. Department of Health and Human Services, examines rates of infections from hospital surgeries and procedures to determine which hospitals are the lowest performing in patient safety. The hospital-acquired complications often take place after procedures such as hysterectomies, colon surgeries and the insertion of urinary tract catheters and central line tubes. Complications such as bed sores, hip fractures, and blood clots are also factored into the hospital scores, along with other complications.
The Federal Agency for Healthcare Research and Quality estimates there were 3.8 million hospital injuries last year, which amounts to 115 injuries for every 1,000 patient hospital stays, according to East Bay Times. Approximately a quarter of a million of those injuries involve patients who became infected with bacteria resistant to antibiotics while in the hospital.
The CDC estimates that 2 million people acquired antibiotic-resistant infections last year, 23,000 of whom died. They estimate that between 20 and 50 percent of all antibiotics prescribed in hospitals are either not needed or inappropriate. The overuse of antibiotics — not just in hospitals but among outpatients and in farm animals used in our food supply — has led to the spread of stubborn bacterial strains that can be deadly for patients who become infected with them.
The government informed the hospitals that they would be cutting 1 percent of their Medicare payments as a penalty for the high rates of injuries, which is expected to cost larger hospitals over a million dollars each. The cuts will affect Medicare payments over this federal fiscal year, which runs from October 2016 through next September.
The federal government does not penalize specialized hospitals, such as those that treat psychiatric patients, veterans, and children, which are exempt from the penalties. Hospitals that are designated “critical access” facilities because they are the only provider in the area are also exempt from the penalties. The Affordable Care Act requires that Medicare penalize the lowest performing 25 percent of the remaining hospitals, even if they have reduced their complication, injury, and infection rates from previous years.
The penalized hospitals will lose about $430 million in total, which is 18 percent more than they lost last year, according to an estimate from the Association of American Medical Colleges.
To see if your area hospitals are on the list of those penalized, you can refer to Kaiser Health News, which has listed all of the low-performing hospitals that were penalized nationwide. The database is searchable, allowing you to search by city, state or hospital name. Note that Maryland hospitals are exempted from the penalties because Maryland has a separate payment arrangement with Medicare.
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