title: Medicare's policy to limit payment for hospital-acquired conditions: the impact on safety net providers.
abstract: In 2008, Medicare implemented a policy limiting reimbursement to hospitals for treating avoidable hospital-acquired conditions (HACs). Although the policy will expand nationally to Medicaid programs in 2011, little is known about the impact on safety-net hospitals. Using data from the 2006 American Hospital Association Annual Survey and MEDPAR, we compared the incidence of cases that met the HACs criteria at safety-net and non-safety-net hospitals. We found that safety-net hospitals had an average of 65.5 HACs per 1,000 Medicare discharges compared with 57.6 at non-safety-net hospitals. Hospitals in the lowest quintile for financial margins had higher rates of HACs on average than other hospitals. Safety-net hospitals and hospitals with the lowest financial margins may be more likely than others to be affected by policies that reduce payment for HACs.
authors.affiliation: Northwestern University, Chicago, IL, USA. megan-mchugh@northwestern.edu
authors.forename: Megan
authors.initials: M
authors.lastname: McHugh
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Martin
authors.forename: John
authors.initials: J
authors.lastname: Orwat
authors.forename: Kevin Van
authors.initials: KV
authors.lastname: Dyke
mesh_terms: D000058:Accidental Falls / Q000191:economics; D055499:Catheter-Related Infections / Q000191:economics; D003428:Cross Infection / Q000191:economics; D004469:Economics, Hospital; D005547:Foreign Bodies / Q000191:economics; D006291:Health Policy / Q000191:economics*; D006761:Hospitals / Q000145:classification* / Q000706:statistics & numerical data; D006801:Humans; D006278:Medicare / Q000191:economics*; D003668:Pressure Ulcer / Q000191:economics; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms; D013530:Surgical Wound Infection / Q000191:economics; D014481:United States; D014947:Wounds and Injuries / Q000191:economics