Medicare Policy Might Discourage Proper Care for Hospital-Acquired Infections
It is even more problematic that Medicare relies on existing hospital billing systems to identify infections and determine when additional reimbursement should be denied. These billing systems were not designed to accurately track hospital infections. Further, patients with infections often have other complications that earn the same level of reimbursement from Medicare. This effect is that Medicare will fail to identify most of the infections it aims to find and that, when cases of hospital infection are identified, these cases will rarely see any change in reimbursement.
The recent Medicare policy may even perversely discourage hospitals from treating infections properly once they arise. Serious complications of infections that are responsible for high mortality, such as sepsis, are not considered under the policy. This means that while relatively minor infections may not be reimbursed, if these infections become serious, hospitals likely will be reimbursed for the additional costs of treating the more severe complications.
Many bloggers have opined that the “never event” policy had significant problems. This well done rant explores the problem of “preventable” infections.
We do need to incentivize infection safety in hospitals. I doubt that administrative data will provide the answer to documenting those infections.
