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Medicare's policy not to pay for treating hospital-acquired conditions: the impact
Peter D McNair1, Harold S Luft, Andrew B Bindman
1Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (UCSF), CA, USA. peter.mcnair@dhs.vic.gov.au
Abstract:
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.
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