CMS is reducing Medicare payments by 1% to more than 700 hospitals in fiscal year 2015 as part of a federal penalty program designed to reduce hospital-acquired medical conditions and improve patient safety.
CMS has announced that approximately 724 hospitals ranked in the bottom quartile for hospital-acquired conditions (HAC) in 2014 and, as a result, will have their payments reduced by 1% for the following fiscal year for all hospital discharges starting on or after October 1, 2014.
The Hospital-Acquired Condition (HAC) Reduction Program, established as part of the Affordable Care Act, is part of CMS’s effort to pay for performance rather than for volume of services by penalizing hospitals that rank in the bottom quartile for hospital-acquired conditions.
Specifically, the program assesses rates of certain patient injuries at hospitals, including blood stream infections, patient falls, bed sores, urinary tract infections, pulmonary embolisms, and blood clots. CMS calculates each facility’s HAC score on a scale from 1 to 10, with 10 being the greatest rate of patient injury. Penalties are reassessed annually.
According to a HHS Report on patient safety published on December 2, 2014, a reduction in hospital acquired conditions has saved $12 billion between 2010 and 2013.
Many hospitals, however, have pointed out that hospitals providing care to the sickest patient populations are disproportionately penalized under the HAC Reduction Program.