Medicare’s Policy Not To Pay For Treating Hospital-Acquired Conditions: The Impact

• DOI: 10.1377/hlthaff.28.5.1485
• Publication Date: 2009-09-09T02:01:07Z
• Authors: Peter D. McNair; Harold S. Luft; Andrew B. Bindman
• Keywords: Prospective payment system; Pay for Performance

In 2008 Medicare stopped reimbursing hospitals for treating eight avoidable hospital-acquired conditions. Using 2006 California data, we modeled the financial impact of this policy on six such Hospital-acquired conditions were present in 0.11 percent acute inpatient discharges; only 3 these affected by policy. Payment reductions negligible (0.001 percent, or $0.1 million—equivalent to $1.1 million nationwide) and are unlikely encourage providers improve quality. Options strengthen incentives include further payment modifications expanding condition exclude consequences, additional procedures, readmissions.