Starting this fall, the Medicare program will start penalizing hospitals that have high rates of infections and preventable injuries. As part of the Affordable Care Act, all eligible hospitals will be ranked and those falling in the bottom 25%, Medicare billings will only be paid at 99% — resulting in a 1% penalty for the fiscal year. Hospitals will be reassessed annually, and the criteria are likely to expand.
Hospital-Acquired Condition Reduction Program
Called the Hospital-Acquired Condition Reduction Program, the penalties are expected to add up to $330 million over a year. The Centers for Medicare and Medicaid Services (CMS) conducted a preliminary assessment that placed 761 hospitals in the lowest-quartile penalty zone.
The scores were based on the rates of infections in patients with catheters in major veins and bladders. Also included were rates of eight patient injuries, such as blood clots, bed sores, and accidental falls.