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Several linked hospitals in western Pennsylvania are being fined for ranking among the nation’s top 25% for rates of potentially preventable illnesses such as infections and injuries.
The 2021 fines for hospital acquired illnesses affect a total of 774 hospitals nationwide, reports Kaiser Health News. The specific dollar amounts of penalties – 1% of each hospital’s Medicare revenue – won’t be available for several months.
Established by the Affordable Care Act, the Centers for Medicaid & Medicare Services Hospital Reduction Program aims to promote incentives for hospitals to improve patient safety and reduce preventable negative outcomes, such as hip fractures. post-surgical, bedsores, blood clots and sepsis.
The program punishes a quarter of hospitals with the worst results – a framework that some critics and hospital advocates dismiss as too unfair, arbitrary and short-sighted.
“No single scoring system can accurately measure the quality of healthcare, especially in a complex academic medical center like UPMC, and patients should talk to their doctors when reviewing this information and making decisions about it. their care, ”said Tami Minnier, UPMC’s quality manager in a statement. “Because UPMC takes ‘the sickest of the sick,’ we – and other academic medical centers across the country – are most often penalized by CMS. …
“Nonetheless, we support the transparent sharing of CMS and other quality measures to improve the performance of all hospitals.”
Among those penalized this year for nosocomial diseases, based on patient data from 2017 to 2019:
• UPMC Presbyterian Shadyside
• UPMC East in Monroeville
• UPMC Memorial in York
• Excela Health’s Frick Hospital at Mt. Pleasant.
Excela Health’s chief medical officer, Dr Carol Fox, stressed that the regional hospital system remains “committed to safety and quality in all aspects of care”. Fox pointed out that since the data used to determine the fine against Frick Hospital is from 2017, the sanction “delays our improvement efforts.”
“A lot of work has been done and continues to decrease hospital-acquired illnesses and readmissions at each of our facilities,” Fox said in a statement. “Our goal is to reduce and ultimately eliminate nosocomial illnesses and unplanned readmissions within 30 days.”
Since the Hospital Acquired Reduction Program began sanctioning facilities via lower payments in 2015, nearly 2,000 hospitals have been penalized at least once and 1,360 hospitals have been penalized more than once, according to an analysis from Kaiser Health News. Seventy-seven hospitals were punished every seven years, including the UPMC Presbyterian Shadyside.
Minnier said the UPMC Presbyterian Shadyside “gets over 25% of its admissions from other hospitals – so we are often the last, best hope for these patients.
The sanctions list and the methodology behind it do not reflect the improvements underway or “fully take into account the severity and complexity of the diseases we treat,” said Minnier.
“We have many efforts in place across our system to reduce hospital acquired illnesses and infections, and we are seeing system-wide declines in these rates on many important metrics as we look at our data in real time.” , said Minnier. “Additionally, our significant efforts to improve the patient experience at UPMC, as measured by patient feedback, have shown dramatic increases.”
The American Hospital Association, which represents nearly 5,000 hospitals and health care systems across the United States, criticizes the operation of the sanctions program, saying it “needs better metrics that accurately reflect performance on issues important ”.
“We support well-designed incentive pay programs, but the HAC reduction program is flawed,” says the AHA. “The program does not take into account the improvements made to patient safety by hospitals. The program unfairly penalizes teaching hospitals, large hospitals and small hospitals. The HAC reduction program needs to be reformed to promote improvement more effectively. “
Several types of hospitals and hospital units are excluded from the sanctions program, including psychiatric, children’s, long-term care and rehabilitation units; Veterans’ hospitals and medical centers; and hospitals deemed to provide “critical access” to an underserved area.
On a typical day in the United States, 1 in 31 hospital patients suffer from at least one healthcare-related infection, according to the Centers for Disease Control and Prevention.
Natasha Lindstrom is a writer for Tribune-Review. You can contact Natasha at 412-380-8514, [email protected] or via Twitter .
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