An Assessment of the Relationship Between Hospital Reimbursements and Hospital-acquired Infections
Patients enter healthcare systems and hospitals to maintain their health, prevent disease, and receive care and treatment from injuries or illness, but no one expects to become more injured, nor sicker, while in the care of these health systems. To ‘do no harm’ is a foundational phrase to all healthcare providers, clinical staff, and administrative personnel, yet patients continue to suffer from preventable hospital-acquired infections. Efforts have been put in place by the Centers for Medicare and Medicaid (CMS) to negatively reinforce hospitals through reimbursement reductions that do not prevent these infections from occurring. This quantitative, retrospective study aimed to explore whether decreases in CMS reimbursements to hospitals from the HACRP policy have impacted the rates of hospital-acquired infections across the United States. The results of this study found significant differences from the pre-policy and post-policy review periods, validating the efficacy of the HACRP policy, and showing a reduction of overall hospital-acquired infections in the post-policy period. The most significant finding was that the hospitals who would have received a payment reduction from HACRP scores in 2013 (pre-policy), showed the most improvements in reducing hospital-acquired infections in the post-policy period of 2019. Based on these findings, CMS and its beneficiaries could benefit even more by incorporating the same payment reduction methodology against the many other hospital-acquired conditions not included in the HACRP. Additionally, private health insurers may also find benefit in applying the same methodology to seek reductions in costs, and put the onus on the hospitals to keep their patients safe and free, from hospital-acquired infections.Keywords: CMS, HACRP, hospital-acquired infections, reimbursement
CMS, Financial Disencentive, HACRP, Hospital-Acquired Infections, Reimbursement
Networked Digital Library of Theses and Dissertations