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Financial Incentives for Preventing HAIs Don't Add Up to Much

Cheryl Clark, for HealthLeaders Media, September 5, 2013

The result was a paper published Monday in JAMA Internal Medicinein which the cost of five types of hospital infections tallied up to a scary $9.8 billion a year. A third of that figure is attributed to surgical site infections alone.

The actual total cost is much greater, because the project only counted infections in hospitals paid under Medicare's inpatient prospective payment system (IPPS). Researchers excluded pediatric acute care and many other settings.

Absent this HAI cost awakening, federal rules now include four penalties or disincentives for higher HAI rates, but they are so meaningless in terms of their dollar amounts, that I'm calling them Chump Change, Mickey Mouse, Chicken Feed, and Peanuts.

1. Chump Change
Under the Deficit Reduction Act of 2005, Medicare is prohibited from reimbursing hospitals additional costs to deal with extra care required for a patient who develops any of 10 hospital-acquired conditions, three of which are infections not present on admission. These are:

  • Catheter associated urinary tract infections
  • Vascular-associated infections and
  • Surgical site infections following coronary artery bypass graft, orthopedic, bariatric, and cardiac implantable electronic device procedures.

But because hospitals are allowed to upwardly adjust the billing code for patients who are seriously ill, the dollars lost are ridiculously small.

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