MRSA Progress Brings Hope for Hospitals’ Ability to Adapt

Anyway, hospitals have been able to decrease the incidence of the hospital-acquired infections caused by this bug by 9.4% a year from 2005 to 2008, the latest period for which data is available. By any measure, that's significant.

This reduction in infection rates hasn't happened by accident—or because the infections have gotten any less virulent. It happened because hospitals and their leaders, on both the physician and executive side, made it a priority. In some ways, the stick, rather than the carrot, has pushed this improvement.

Certainly, hospitals and physicians don't wish to do patients harm, but in the miasma of responsibilities involved in caring for patients, it's often easy to ignore something that doesn't have revenue attached to it. That's why handwashing and other sterilization procedures for too long were routinely ignored.

MRSA infections can be deadly. But more importantly, they're extremely expensive, adding days or longer to hospital stays for people who should have been able to go home much sooner. They also add costly drugs and much unnecessary pain and suffering to the equation. But perhaps most importantly they add cost—costs for which hospitals are increasingly on the hook.

Payers, including Medicare, have discovered that hitting healthcare organizations in the pocketbook is a sure way to get their attention. That the decrease came at the same time Medicare was implementing payment punishment when so-called "never events" happened, is probably no coincidence.

In the same way, perhaps a better focus on cost will further the goals of cheaper and safer care. No one can yet say for sure what healthcare reform will do to reimbursement, but most senior leaders I speak to think it will make hospitals financially weaker, because although more people will be covered by insurance, reimbursement per patient will actually drop, for reasons that are too complex to get into here.