Medicare reimbursement incentive less than effective

Reuters, September 5, 2012

Record-keeping for a patient complication used by Medicare to determine how much hospitals get reimbursed is not comprehensive or accurate, undermining the policy's value, a new study suggests. In an effort to get more for their money, the Centers for Medicare & Medicaid Services (CMS)—as well as some individual insurance companies—don't reimburse hospitals for certain conditions listed on billing records that are costly and believed to be preventable. One such example is urinary tract infections (UTIs) acquired in the hospital as a result of using a urinary catheter.


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