Pader Moua, MPH
Thirteen Arkansas hospitals face penalties of 1% reductions in Medicare payments in federal fiscal year 2022 for high rates of hospital-acquired conditions, up from 10 hospitals in 2021 and 2020. Thirty-four hospitals were not penalized and 40 were exempt.
The Centers for Medicare and Medicaid Services (CMS) assigned the penalties under a program that determines which hospitals have the highest self-reported rates of infection with five conditions: bloodstream infection from a central line, urinary tract infection from a catheter, methicillin-resistant Staphylococcus aureus, surgical infection from an abdominal hysterectomy or colon procedure, and Clostridium difficile infection.
The increase in the number of Arkansas hospitals penalized is not surprising given that the measurement period occurred during the height of the COVID-19 pandemic, from October 2020 to September 2021, when hospital staffing was stretched and both administrative and clinical focus was dedicated to emergency response efforts. The Centers for Medicare and Medicaid Services has indicated that the agency has no flexibility to modify or waive penalties during the pandemic and that the penalty amounts are determined by federal law. Hospitals and researchers have pushed for reform of the program, contending that the incentives are not aligned because hospitals are penalized more for diligence in self-reporting infections.
Of the 13 Arkansas hospitals facing penalties for high rates of hospital-acquired conditions, 12 are also subject to reductions in Medicare payments of up to 3% for high 30-day readmission rates. Washington Regional Medical Center in Fayetteville is the only hospital among the 13 facing hospital-acquired conditions penalties that will not also face a readmissions penalty. As we reported in a previous blog post, 39 Arkansas hospitals face penalties in federal fiscal year 2022 for high 30-day readmission rates, which is down from 40 hospitals in 2021 and 41 hospitals in 2020. The average penalty per hospital also went down, from 0.82% in 2021 to 0.78% in 2022.
The Arkansas hospitals subject to the hospital-acquired conditions penalty in 2022 are:
The 39 Arkansas hospitals subject to readmission penalties in 2022 are:
CMS’Â Hospital Readmissions Reduction ProgramÂ (HRRP) and its Hospital-Acquired Condition Reduction Program seek to improve health care by linking hospital payments to quality of care. Some facilities are exempt, including veterans’ hospitals, children’s hospitals, psychiatric hospitals, critical access hospitals, and hospitals with too few cases to assess.
Technology is also being leveraged to monitor and prevent patient readmissions. In Arkansas, the state’s health information exchange, the State Health Alliance for Records Exchange, or SHARE, launched aÂ 90-day readmission projectÂ to help reduce readmissions. The project allows a participating hospital to receive a secure message notification when a patient is discharged from its facility and readmitted to any SHARE-participating hospital within a 90-day time frame.