Medicare's policy not to pay for treating hospital-acquired conditions: the impact.
In 2008 Medicare stopped reimbursing hospitals for treating eight avoidable hospital-acquired conditions. Using 2006 California data, we modeled the financial impact of this policy on six such conditions. Hospital-acquired conditions were present in 0.11 percent of acute inpatient Medicare discharges; only 3 percent of these were affected by the policy. Payment reductions were negligible (0.001 percent, or $0.1 million-equivalent to $1.1 million nationwide) and are unlikely to encourage providers to improve quality. Options to strengthen the incentives include further payment modifications for hospital-acquired conditions or expanding the hospital-acquired condition policy to exclude payment for consequences, additional procedures, and readmissions.
McNair
Peter D
PD
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (UCSF), CA, USA. peter.mcnair@dhs.vic.gov.au
Luft
Harold S
HS
Bindman
Andrew B
AB
D002140:California; D014487:Centers for Medicare and Medicaid Services, U.S.; D003428:Cross Infection / Q000191:economics*; D006291:Health Policy; D006801:Humans; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence; D010351:Patient Discharge; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*; D014481:United States