Truman Medical Center Hospital Hill is among 175 hospitals nationwide most likely to be penalized with the loss of Medicare payments because of high rates of infection and other complications.
In April, the Centers for Medicare & Medicaid Services calculated preliminary “hospital-acquired condition” scores from 1 to 10, with one being best and 10 being worst.
Truman was the only hospital in the Kansas City area that received a preliminary score of more than 9. Experts say hospitals with preliminary scores of nine or higher are the ones most likely to get hit with the penalty, according to Kaiser Health News.
Hospitals with scores above seven risk losing 1 percent of each Medicare payment from Oct. 1 through Sept. 30, 2015. Medicare has identified about a quarter of the nation’s hospitals – 761 altogether – as falling into that category.
Besides TMC Hospital Hill, six other area hospitals – out of nearly two dozen – received preliminary scores of more than seven. (See chart)
Mark Steele, the chief medical officer of Truman, acknowledges that during the period covered by the preliminary scores, Truman “had an undesirable rate of urinary tract infections and blood stream infections.”
“Though it should be noted,” he wrote in an email to KCUR, “that blood stream infections show up individually and in the serious complications listing, so that is essentially a double counting of the same infection. We should also note that typically academic medical centers, like TMC, tend to have higher rates of patients with pre-existing infections and/or multiple diseases that make them far more susceptible to these issues.”
Steele says the hospital took immediate corrective action upon discovery of the higher-than-normal rates, including additional education and training. He also says Truman “saw significant reductions in these issues” in 2013, bringing its numbers below the national average.
“TMC takes the quality of the care we provide very seriously and is consistently improving our methods and working to find the best ways to care for our patients,” Steele says.
The penalties will be assessed under the government’s Hospital-Acquired Condition Reduction Program, one of three mandatory pay-for-performance programs created by the 2010 Affordable Care Act.
The preliminary scores were calculated based on rates of infection in patients with catheters in major veins and their bladders as well as eight other injuries, including blood clots, bed sores and accidental falls, Kaiser Health News reports.
The data covers the 12-month period from July 2012 to June 2013.
Later this year, Medicare will release the final scores, which may differ from the preliminary ones because they will cover infections over two years, not one.
Because some scores will change due to the longer data collection period for infections, Truman may end up not being penalized.
Related coverage from NPR: Hospitals to pay big fines for infections, avoidable injuries