Hospitals Face Crackdown for Patient Injuries—Lose Medicare Payments
According to statistics, nearly one in four hospitals in the United States will lose some portion of Medicare funding this year because their negligence led to patient injuries. The Medicare funding that hospitals receive is subject to annual review. The federal government has put stringent guidelines in place governing infection rates in hospitals, and those that fail to meet the requirements risk loss of significant funding.
Federal officials acknowledge that, overall, infection rates have come down at hospitals across the United States, but insist that the numbers are still unacceptably high. A 2012 study showed that one of every eight hospital patients sustained a potentially avoidable complication while in the hospital and that approximately one of every 25 hospital patients contracts an infection.
The actions by federal officials are pursuant to the 2010 Health Care Reform Act, which put in place what is known as the “Medicare Pay-For-Performance” guidelines. Dubbed the Hospital-Acquired Condition (HAC) Reduction Program, it assesses penalties based on high readmission rates, as well as a number of other factors, including frequency of infections and the avoidability of safety risks to patients.
Medicare has been working on the problem since before the enactment of Health Care Reform. Since 2008, Medicare has denied reimbursement to hospitals for any expenses associated with the treatment of avoidable complications.
Hospital officials contend that they have taken serious steps to reduce the risk of injury and infection, but assert that infection is a known risk of many medical procedures.
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