CMS Cuts Payments to 774 Hospitals for Hospital-Acquired Conditions
CMS will reduce 774 hospitals’ Medicare payments in fiscal year 2021 for having the highest rates of patient injuries and infections by 1%. These penalties are based on inpatient hospital admissions from mid-2017 to 2019 before the COVID-19 pandemic.
Under the Affordable Care Act, the Hospital-Acquired Conditions Reduction Program was created to prevent harm to patients by providing a financial incentive for hospitals to prevent hospital-acquired conditions (HACs). A hospital’s total score is based on performance for several quality measures, including rates of infections, blood clots, bedsores and other complications which occur in the inpatient hospital setting; and might have been prevented.
Now in its seventh year, the Hospital-Acquired Conditions Reduction Program has been argued by the hospital industry to be arbitrary in its appropriation. Some hospitals have claimed they were penalized because they were more thorough in their finding and reporting of HACs to CMS than other hospitals.
Medicare excludes all Maryland hospitals from the program because it pays them through a different arrangement than in other states. Specialty hospitals such as children’s’ hospitals, veterans’ hospitals, psychiatric hospitals, and Critical Access Hospitals are also excluded from the program.
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