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Healthcare-Associated Infection Costs Detailed

Cheryl Clark, for HealthLeaders Media, September 3, 2013

Another incentive, passed last year, requires state Medicaid programs to each formulate their own policies to deny payment for certain preventable adverse events such as healthcare-associated infections.

For further reductions of healthcare-associated infections, hospitals need greater incentives, such as expanded Medicare penalties, and adding to a list of adverse events won't be reimbursed by all payers including health plans, and a shift from fee-for-service to bundled payments, Zimlichman says.

"Obviously, as we slowly phase out of our fee-for-service approach, we're going to see hospitals investing much more in efforts to battle these complications, and there's no doubt about that. But again, if we're just showing the numbers, and there's no policy change, and no risk to the providers, it's doubtful how much difference this is going to make."

He adds that some progress is happening, although slowly. Some heath plans are adopting policies to refuse reimbursement for avoidable adverse events, such as preventable infections. "The game is starting to change," he says. "We know for example that 75% of infections are preventable," and special initiatives such as Michigan's keystone project have reduced CLABSI to zero.

In an accompanying editorial, journal editor Mitchell Katz, MD, wrote that healthcare administrators need motivation "to invest in the necessary systems to decrease these infections." Such costs might include information technology systems to minor rates following interventions, education of clinicians, time to continually reassess patients' need for catheters, lines, and ventilator support, and effectiveness of measures such as chlorhexidine baths.

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3 comments on "Healthcare-Associated Infection Costs Detailed"


Richard Weinberg MD (9/9/2013 at 3:25 PM)
Dr. Angel's frustration is easily understood but he misstates the reasoning behind the quality improvement process and the financial penalties to which he refers. The penaities are not designed to be levied on every post op infection; rather, they are designed to be levied on hospitals and surgeons whose infection rates are much higher than the "norm." The wide variation in these rates, which are risk and severity adjusted, is well documented and the CMS programs are designed to get the high-infection-rate institutions and physicians to do better.

Jeff Angel, M. D. (9/4/2013 at 6:43 PM)
Interesting article. Again, putting all the blame on hospitals and surgeons. Wow, why don't we get rid of hosptials and surgeons. Problem solved and save all those calculated dollars. Seriously, much work has been done by hospitals and doctors, but switching to a system that penalizes any infection with not paying someone for 5 days(that is what some of the extreme measures state) or shutting down hospitals, does that really help population? Sometimes, a surgical site infection is going to be 15%, no matter what...does that mean no one is going to do a great surgery, because of an expected infection rate????????????? What about the non-compliant patient[INVALID]refuse life-saving surgery or repairing a shattered femur after car wreck, because if it becomes infected or dvt occur because they smoke, have diabetes, cancer, or some other illness[INVALID][INVALID]-I'M responsible!!?????? Articles like this are sickening to surgeons[INVALID][INVALID]we are doing every swab, hibiclens, stratifying patient, etc we CAN DO!!!!!!!!!!! SURGEONS ARE NOT PROBLEM!!!! Why not run some counter articles. Sickening to see one side constantly!!!!!!!!!!! Dock my pay for expected rate of complications and cut my pay to near zero....who is going to take care of your shattered femur?

PRD (9/4/2013 at 1:40 PM)
I think you meant ventilator- a ssosciated RESPIRATORY tract infections.