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

Among some of the researchers findings:

• 81% of the infection preventionists who responded report that their hospitals now put greater focus on those healthcare-associated infections that CMS targets for non-payment. However, in one-third of the hospitals, the policy has resulted in less time spent on preventing non-targeted healthcare-associated infections.
• A majority of respondents said they spend more time on surveillance of patients for CAUTIs because of the new law. For example, front line staff are quicker to remove urinary catheters and central venous catheters when they're not needed.
• More than one-third of hospitals' preventionists said they more frequently use antimicrobial-coated or impregnated urinary catheters.
• One-third of hospitals said they use diagnostic tests without clinical indication, for example, routinely obtaining urine and blood cultures on admission to document presence of infections to avoid getting blamed later for causing them, and having to absorb a Medicare financial penalty.

The law that took effect in 2008 was part of the Deficit Reduction Act of 2006. And according to an Office of Inspector General's report from November, 2010, the codes for hospital-acquired conditions "often had no effect on costs because the claims included other costly diagnoses or procedure codes that elevated the reimbursement to equivalent or higher amounts."