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Medicare Trims Payments to 800 Hospitals, Citing Patient Safety

Those with the highest rates of infections and injuries are penalized each year

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En español | Eight hundred hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries, federal records show.

The number is the highest since the federal government five years ago launched the Hospital Acquired Conditions (HAC) Reduction Program, created by the Affordable Care Act. Under the program, 1,756 hospitals have been penalized at least once, a Kaiser Health News analysis found.

This year, 110 hospitals are being punished for the fifth straight time.

The penalties pit hospitals against one another in a race to prevent the most infections, blood clots, cases of sepsis, bedsores, hip fractures and other complications. Each year, the quarter of general hospitals with the highest rates are punished, even if their records have improved from the previous year.

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Under the latest sanctions, each hospital will lose 1 percent of its Medicare payments for patients discharged between last October and this September. That comes on top of other penalties created by the health care law, such as payment reductions for hospitals with too many patients being readmitted.

The hospital industry has protested the HAC penalties, saying the program’s design creates an arbitrary cutoff for which institutions get punished. The American Hospital Association calculated that only about 41 percent of the 768 hospitals penalized in 2017 had HAC scores that were statistically significantly higher than hospitals not being penalized.

“There are not statistical differences that would warrant a quarter of the hospitals in America getting a penalty,” said Nancy Foster, the association’s vice president for quality and patient safety.

Hospitals also complain that the ones that do the best job testing infections and other threats to patients appear to be among the worst based on statistics.

Supporters of the punishments argue that they prod hospitals to improve quality.

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