CMS Nonpayment Policy Has Not Reduced Infections

No decrease in catheter-linked bloodstream and urinary tract infections since policy initiation

WEDNESDAY, Oct. 10 (HealthDay News) -- Implementation of the Centers for Medicare and Medicaid Services (CMS) policy to reduce payment for preventable hospital-acquired conditions in October 2008 has not impacted infection rates in U.S. hospitals, according to a study published in the Oct. 11 issue of the New England Journal of Medicine.

Grace M. Lee, M.D., from the Harvard Pilgrim Health Care Institute and Harvard Medical School in Boston, and colleagues utilized data from the National Healthcare Safety Network to examine changes in trends in central catheter-associated bloodstream infections and catheter-associated urinary tract infections (both targeted by the CMS policy) as compared with ventilator-associated pneumonia, which was not targeted by the policy. Data were included from 2006 through March 2011.

Based on data from 398 hospitals or health systems (14,817 to 28,339 hospital unit-months), the researchers found that there were decreasing secular trends for both targeted and non-targeted infections observed before implementation of the policy. Following implementation of the policy, there were no significant changes in the quarterly rates of central catheter-associated bloodstream infections, catheter-associated urinary tract infections, or ventilator-associated pneumonia. The results were similar for hospitals in states without mandatory reporting and did not differ based on quartile of percentage of Medicare admissions or hospital size, type of ownership, or teaching status.

"In this national evaluation of the effect of the CMS policy of nonpayment for preventable complications on patient outcomes, we found no evidence that financial disincentives reduced infection rates," Lee and colleagues conclude.

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