Hospitals with Too Many Safety Issues Punished by Medicare

Hospitals across the country must operate in accordance with safety standards set by the federal government or else face being penalized by the Medicare payment system. Many hospitals rely on Medicare to function, and as such, this is a powerful incentive to comply with guidelines. However, 751 hospitals in the United States have been penalized by the federal government recently for having unsafe environments that led to too many infections and patient injuries. According to NPR, “Out of the roughly 3,300 general hospitals that are evaluated each year, Medicare must punish the worst-performing quarter of them—even if they have reduced their number of potentially avoidable mishaps from the previous evaluation period.” As a result, the hospitals at the bottom of the list lose one percent of their Medicare funding, motivating them to perform better the following year. When assessing the safety of the Hospitals, Medicare looks at include rates of infections from surgeries, hysterectomies, urinary tract catheters and central line tubes inserted into veins. Medicare also examines rates of methicillin-resistant Staphylococcus aureus, or MRSA, and Clostridium difficile, known as C-diff. Additionally, Medicare examines the frequency of 10 types of in-hospital injuries—including bedsores, hip fractures, blood clots, sepsis and post-surgical wound ruptures.

All States are subject to these penalties, except for Maryland because they have a different Medicare payment system. The rate of hospitals penalized however, is not consistent throughout the United States. According to the U.S. Centers for Medicare and Medicaid Services, both Delaware and Connecticut have 50 percent of their hospitals receiving penalties from the federal government. Likewise, the District of Columbia has 43 percent of their hospitals penalized in the same way. Medicare is reducing its payments to 15 different Hospitals in New Jersey because of the increase in hospital-acquired infections, falls, blood clots or other injuries suffered by patients.

Delaware is tied for being the worst state in hospital safety, in that half of its hospitals are on Medicare’s penalty list. However, Delaware has been making efforts to make its hospitals safer and cleaner. Dr. Gary Siegelman, chief medical officer at Bayhealth, said “[their] efforts have led to improved patient outcomes that are better than national targets.” He claims that the hospital is doing this by using new cleaning equipment, improving patient room cleaning procedures and teaching nurses, doctors and technicians about certain precautions.

Of course, reducing hospital-acquired conditions by any measurable amount—even just one percent—is obviously a desired result for all hospitals, states board chairman of patient-advocacy group Health Watch USA, Dr. Kevin Kavanagh. “[While] no system is perfect,” he emphasizes, “that’s really the bottom line that everyone should support.”