What is it about?
The article raises concern over the way in which the Centers for Medicare and Medicaid Services develop and apply payment system penalties for hospital acquired complications
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Why is it important?
This article opens by repeating and confirming the observation that the penalties applied by CMS within the hospital acquired complication reduction program (HACRP) are being disproportionately levied on teaching hospitals and those hospitals with more complex case mix. It goes on to demonstrate that the penalties are wildly disproportionate to measured differences and that comparison to a more comprehensive system results in both a different assignment of hospital penalties and holds the potential to provide more granular distinction in penalties matched to performance. This is important as a broader consideration of hospital acquired conditions is necessary to improve hospital quality and limitations of the current penalty system are putting undue financial strain on hospitals that are already achieving higher relative quality outcomes.
Perspectives
This article was written to help those looking at the incentive structure being developed by CMS in its efforts to promote quality to gain better perspective on its mechanics. There is a worrying trend emerging in which a small slice of activity is used to leverage a performance incentive applicable to the whole of which the HACRP is but one example.
Mr Richard L Fuller
Read the Original
This page is a summary of: Is the CMS Hospital-Acquired Condition Reduction Program a Valid Measure of Hospital Performance?, American Journal of Medical Quality, April 2016, SAGE Publications,
DOI: 10.1177/1062860616640883.
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