Medicare's 'No-Pay' HAI Policy Reshifts Hospital Priorities

"As a consequence, some hospitals reported they needed to shift their resources and their efforts to be able to respond," specifically to efforts that prevent central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI).

The fact that the Affordable Care Act calls for public reporting of each hospital's HACs, and a separate penalty, has played a role as well, Lee says. "Notoriety from public reporting is important. It's a strong incentive," that has hospital leadership to give a stronger response to these efforts.

The infection preventionists told the Harvard researchers that it was their perception that they didn't have enough resources to focus on things that were more important, Lee adds. "For example, some hospitals felt that catheter-associated urinary tract infections, a CMS reduction target, resulted in lower morbidity and mortality and lower cost, and less of an impact on the patient."

Improving physician documentation and surveillance to capture those times when patients were already infected when they came to the hospital, with "present on admission" coding, is being emphasized far more.  And less time is spent educating clinicians on handwashing, and in preventing infections in other ways, she says.