Evidence Key to CMS dollars for Hospital Acquired Conditions

mrsa_1200.jpgAs part of the Patient Protection and Affordable Care Act (ACA), the Hospital-Acquired Condition Reduction Program (HACRP) was established to incentivize hospitals to reduce the number of HAC’s per year (Source:www.cms.gov). HAC’s differ slightly from hospital-acquired infections (HAI’s) although both designations fall under the regulations set forth by the HACRP.

  • HAI’s: infections patients may contract while under treatment in a healthcare facility (urinary tract infections, sepsis, etc).
  • HAC’s: any other situation or condition that may occur (including medication errors, pressure sores, falls).

An HACRP score above the 75th percentile makes a hospital subject to a 1% CMS payment reduction. The score on the HACRP is determined by six factors, 5 of which are hospital-acquired infections:

  • Patient Safety Indicators 90 Composite (see a breakdown from AHRQ about the PSI 90 here).
  • Central line-associated bloodstream infections
  • Cather-associated urinary tract infections
  • Surgical site infections
  • MRSA infections
  • C-diff infections

“769 of the 3,313 hospitals enrolled in the program were penalized for their number of HAC’s. Of that exceptionally large number, 241 of those hospitals are experiencing these payment reductions for the third year in a row.”

ratings_1200.jpgFor fiscal year 2017, 769 of the 3,313 hospital enrolled in the program were penalized for their number of HAC’s. Of that exceptionally large number, 241 of those hospitals are experiencing these payment reductions for the third year in a row. That’s a 1% reduction for each year the HACRP has been in existence. You can see the full list of the 769 hospitals here.

HAC’s are largely avoidable, but hospitals need to have protocols in place. An incentive-based program like the HACRP was designed to motivate health system administrators to develop said protocols to improve patient care and outcomes. Doing so would simultaneously reduce the cost of treating the HAC’s in addition to the conditions for which the patient was in the hospital in the first place.

Download our FREE whitepaper:The Evolution of Care Bundles for Sepsis 

“Care bundles have been used for conditions such as sepsis, central-line associated bloodstream infections, and urinary tract infections. Sound familiar?”

sepsis_1200.jpgCare bundles have been shown to be an effective solution for the care of numerous conditions. A care bundle is a small set of evidence-based practices that result in better patient outcomes when performed together instead of being implemented individually. Said another way, they are a list of practices clinicians need to follow for every patient, every time to provide them with effective and safe care. Care bundles have been used for conditions such as sepsis, central-line associated bloodstream infections, and urinary tract infections.

Sound familiar?

Want to know more about how evidence-based care bundles can reduce the incidence of HAI’s, which are a key driver of the HACRP score, and save your health system potential millions in Medicare reimbursement? Download our FREE white paper, The Evolution of Care Bundles for Sepsis to learn how to foster a commitment within your organization to an environment of process change and evidence-based medicine.

Free Whitepaper

Topics: Hospitals, Hayes Blog, Healthcare Evidence, Medicare, Consumers

Sign up to receive updates from our blog

Our latest articles

New Call-to-action