What is the Hospital-Acquired Condition (HAC) Reduction Program?
At the start of the 2015 fiscal year, the Affordable Care Act’s Hospital-Acquired Condition (HAC) Reduction Program will take effect. The program is applied through the Centers for Medicare & Medicaid Services (CMS) as a way to improve processes and prevent patients from contracting HACs – conditions that patients acquire while receiving treatment for another condition in a healthcare setting – and is carried out through payment penalties. Hospitals that rank among the lowest-performing 25% with regard to HACs will have their payments reduced by 1%.
What Data is CMS Using to Measure HACs?
According to Kaiser Health News,
In the first year of the HAC program, CMS will look at three measures. One is the frequency of bloodstream infections in patients with catheters inserted into a major vein to deliver antibiotics, nutrients, chemotherapy or other treatments. The second is the rates of infections from catheters inserted into the bladder to drain urine.
Third, CMS will examine a variety of avoidable safety problems in patients including bedsores, hip fractures, blood clots and accidental lung punctures. Over the next few years, CMS will also factor in surgical site infections and infection rates from two germs that are resistant to antibiotic treatments: Clostridium difficile, known as C. diff, and Methicillin-resistant Staphylococcus aureus, known as MRSA.
Each facility is given an HAC score on a scale from 1-10, with 10 being the greatest rate of patient harm. Hospitals that score a 7 or higher will be penalized. Certain types of hospitals are exempt from the penalties, including critical access hospitals, specially designated cancer hospitals and those devoted to rehabilitation, children, long-term care and psychiatric treatment. Also, hospitals with too few cases for CMS to evaluate are exempt.
How Do the CMS’ HAC Preliminary Report Findings Affect Hospitals This Year?
Earlier this year, CMS released a preliminary assessment and identified 761 facilities that could be penalized under the program. The preliminary scores are based on infections during the 12-month period from July 2012 through June 2013. Final scores will include infections that occurred from the beginning of 2012 through the end of 2013.
Data from the preliminary report showed that out of the 311 hospitals in Texas that were scored, 80 received a 7 or higher, which equates to about 26%. The Texas Tribune’s website has provided a map to show which Texas hospitals have been assigned the preliminary penalty. While the scores could change when the final report is released, healthcare experts still expect the hospitals with higher preliminary scores to remain on the final report.
What Can Your Hospital Do to Avoid Penalties?
There is no time to waste; the figures for the next fiscal year are already adding up. You need to start investing in technologies and resources that will help you fight hospital-acquired conditions.