Hospitals with the worst ratings—roughly a quarter of the nation’s hospitals – will lose 1 percent of each Medicare payment they receive for a year starting in October. Back in April, federal officials released an analysis of hospitals they wanted to assess (761 in total). Later this year Medicare will set its final penalties, which may change the list. In the meantime, the government will continue to look at hospital performance.
It is estimated that the sanctions will total $330 million over a year. These sanctions stem from two primary areas: infection (in the bloodstream and from improper catheter maintenance) and avoidable safety problems (which include bedsores, hip fractures, blood clots and accidental lung punctures).
Over the next few years, Medicare will also add surgical site infections and the infection rates of antibiotic resistant infections (Clostridium difficile, known as C. diff, and Methicillin-resistant Staphylococcus aureus, known as MRSA).
The penalties Medicare is going to level will hit some types of hospitals harder than others. Hospitals that are publicly owned—those that treat large portions of low-income patients—are more likely to be assessed penalties. In addition, large hospitals, hospitals in cities and those in the West and Northeast are also more likely to receive penalties.
Teaching hospitals may have the biggest impact. Roughly, 54 percent were marked for penalties. The reason types of elite hospitals are facing complications is still under debate. Luckily, the government will take into consideration the size of the hospital, the location where patients are treated and if being treated at a medical school factors into the infection rate.
Aside from the complications in general, another concern is the difference in the performance between hospitals that received small penalties and those that barely avoided receiving penalty. This is because Medicare is required to punish the worst performing quarter of hospitals each year—regardless if they are improving.
While the chance of you being harmed when you are in the hospital is rare, accidents do happen. If you or a family member has been injured or received a secondary infection while in the hospital and need assistance obtaining compensation, please schedule a free consultation with Tennessee medical malpractice attorneys at Gilreath & Associates, or continue browsing our blog and knowledge center to for other information.