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Medicare's HAC Policy May Not Save Much Money

Kristen Kohrt, for HealthLeaders Media, September 18, 2009

A new study shows Medicare's policy against paying for hospital-acquired conditions (HAC) will only save $1.1 million to $2.7 million.

California researchers conducted the study, which analyzed discharge data from California Medicare beneficiaries in 2006, looking for six conditions the authors deemed definable. Out of the total 767,995 cases, there were 828 cases of those conditions, and 26 would have been subject to lower payments, according to the Wall Street Journal.

"If it's designed to recapture money, it's poorly designed," says Keith Siddel, PhD (c), founder, president, and CEO of HRM in Creede, CO, a national healthcare financial service organization.

A patient's condition upon admission usually generates multiple codes, so if a patient develops a HAC, the nonpayment for that condition will not heavily impact the total reimbursement because of legitimate payment for the rest of the codes, Siddel says.

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