Several hospitals with ties to Western Pennsylvania are fined for being among the 25% nationwide to perform the worst when it comes to the number of possible avoidable patient conditions such as infections and injuries.
The 2021 fines for conditions obtained by hospitals totaled 774 hospitals nationwide, Kaiser Health News reported. The specific dollar amounts for the fines – 1% of the Medicare revenue of each hospital – have not been available for several months.
The Centers for Medicaid & Medicare Services Hospital Acquisition Reduction Program was established by the Affordable Care Act and aims to promote incentives for hospitals to improve patient safety and reduce preventable adverse outcomes, such as hip fractures after surgery, pressure ulcers , blood clots and sepsis.
The program punishes a quarter of hospitals with the worst outcomes – a framework that some critics and proponents of hospitals see as too unfair, arbitrary and short-sighted.
“No single grading system can accurately measure the quality of healthcare, especially in a complex academic medical center such as UPMC, and patients should talk to their doctors while reviewing this information and making decisions about their care,” the UPMC quality officer said. Tami Minnier, in said a statement. “Because UPMC takes the ‘sickest of the sick’, we – and other academic medical centers nationwide – are most penalized by CMS. …
“Nevertheless, we support the transparent part of CMS and other quality measures to improve the performance of all hospitals.”
Among those being penalized this year for hospital-acquired conditions based on patient data from 2017 to 2019:
• UPMC Presbyterian Shadyside
• UPMC East in Monroeville
• UPMC Memorial in York
• Frick Hospital of Excela Health in Mt. Pleasant.
Excela Health’s chief medical officer, dr. Carol Fox, emphasized that the regional hospital system “is committed to safety and quality in all aspects of care.” Fox pointed out that since the data used to determine the fine against Frick Hospital dates back to 2017, the sentence “lags behind our improvement efforts.”
“A lot of work has been done that continues to reduce hospital-acquired conditions and readmissions at each of our facilities,” Fox said in a statement. “It is our goal to reduce and eventually eliminate hospital-acquired conditions and unexpected readmissions within thirty days.”
Since the hospital-acquired reduction program began with lower-paying facilities in 2015, nearly 2,000 hospitals have been penalized at least once, and 1,360 hospitals have been penalized more than once, according to an analysis by Kaiser Health News. Seventy-seven hospitals have been punished for seven years, including UPMC Presbyterian Shadyside.
Minnier said UPMC Presbyterian Shadyside “gets more than 25% of its admissions to other hospitals, so we are the last, best hope for these patients.”
‘The list of penalties and the methodology behind it do not reflect continuous improvement, nor is it an account of the severity and complexity of the diseases we treat,’ Minnier said.
“We put a lot of effort into our system to reduce conditions and infections obtained in the hospital, and see that rates are systematically declining on very important criteria as we look at our real-time data,” Minnier said. “In addition, our extensive efforts to improve the patient experience at UPMC, measured by patient feedback, have increased dramatically.”
The American Hospital Association, which represents nearly 5,000 hospitals and health systems in the United States, criticizes the way the penal program works and says it “needs better measures that accurately reflect performance on key issues.”
“We support well-designed performance programs, but the HAC reduction program is flawed,” says the AHA. ‘The program does not take into account the improvement of patients’ safety provided by hospitals. The program punishes unfair education hospitals, large hospitals and small hospitals. The HAC reduction program needs reform to promote improvement more effectively. ”
Several types of hospitals and hospital units were excluded from the penal program, including units for psychiatric, child care, long-term care, and rehabilitation; Veterans Affairs hospitals and medical centers; and hospitals considered ‘critical access’ to an underserved area.
During a normal day in the United States, 1 in every 31 hospital patients suffers from at least one healthcare-associated infection, reports the Centers for Disease Control and Prevention.
Natasha Lindstrom is an author of Tribune Review. You can contact Natasha at 412-380-8514, [email protected] or via Twitter .
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