Medicare Penalty Appears to Drive Hospital Infection Prevention Efforts

A majority of infection preventionists reported an increase in surveillance, education, and prevention efforts for health care-associated infections targeted by the Centers for Medicare & Medicaid Services policy.

The 2008 decision by the Centers for Medicare & Medicaid Services (CMS) to cease additional reimbursement to hospitals for certain health care-associated infections (HAIs) has led to enhanced focus on infection prevention and changes in practice by front-line staff, according to a national survey of infection preventionists published in the May issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

A team of researchers and public health policymakers led by Grace M. Lee, M.D., MPH, from Harvard Pilgrim Health Care Institute and Harvard Medical School, surveyed head infection preventionists (IPs) at 317 acute care hospitals that were directly impacted by the policy change, which was enacted to motivate hospitals to eliminate preventable infections. According to the survey results, 81 percent of IPs reported increased focus on those HAIs targeted by the policy, namely catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs).

A majority of IPs reported an increase in surveillance, education, and prevention efforts for HAIs targeted by the CMS policy, particularly for CAUTIs. IPs felt that front-line staff removed urinary (71 percent) and central venous catheters (50 percent) more quickly than before, and increased use of antiseptic-containing dressings for central venous catheters (56 percent) for CLABSI prevention.

Although the policy did not appear to have a major impact on funding to support infection prevention departments (77 percent), a closer working relationship between infection prevention and quality improvement departments (57 percent) and greater collaboration by interdisciplinary teams to prevent HAIs (65 percent) was noted in response to the CMS policy.

While most of the findings were positive, the survey did identify some unintended consequences of the policy. One-third of respondents said their hospitals needed to shift resources away from non-targeted infections in order to focus on targeted infections. IPs also expressed concern that hospitals focused greater effort on improving physician documentation and coding practices to avoid negative financial penalties, rather than enhancing infection prevention efforts to improve patient outcomes. Finally, a quarter of respondents reported that their hospitals performed unnecessary diagnostic testing upon admission to avoid potential financial penalties.

“The CMS policy of eliminating additional payment for certain HAIs appears to have had a positive impact on hospital infection prevention efforts, yet careful consideration of the potential for unintended consequences is warranted,” said the study authors. “As CMS expands the list of complications for which it will adjust payment and continues to modify its requirements for reporting, it is critical to ensure that policy changes lead to measureable improvements in patient outcomes while minimizing potential unintended consequences.”

This study is one of the first to assess perceived impact of the CMS payment policy on hospital infection prevention efforts as reported by infection preventionists. Infection preventionists were chosen for the study because of their organizational knowledge of infection prevention surveillance, practices, and documentation.

Download Center

HTML - No Current Item Deck
  • Free Safety Management Software Demo

    IndustrySafe Safety Management Software helps organizations to improve safety by providing a comprehensive toolset of software modules to help businesses identify trouble spots; reduce claims, lost days, OSHA fines; and more.

  • Easy to Use Safety Incident App

    Record incidents on the go with IndustrySafe’s mobile app. Collect data for multiple types of incidents including including near misses, vehicle and environmental incidents, and employee and non-employee injuries; at job sites and remote locations—with or without web access.

  • Safety Training 101

    When it comes to safety training, no matter the industry, there are always questions regarding requirements and certifications. IndustrySafe is here to help. We put together a resource that’s easy to digest so you can get answers to your training questions and ensure you're complying with OSHA's standards.

  • Conduct EHS Inspections and Audits

    Record and manage your organization’s inspection data with IndustrySafe’s Inspections module. IndustrySafe’s pre-built forms and checklists may be used as is, or can be customized to better suit the needs of your organization.

  • Track Key Safety Performance Indicators

    IndustrySafe’s Dashboard Module allows organizations to easily track safety KPIs and metrics. Gain increased visibility into your business’ operations and safety data.

  • Industry Safe
comments powered by Disqus