Nearly 40 hospitals in the Mountain West are being penalized for having high rates of infections, patient injuries or other complications from hospital stays. That鈥檚 according to released last week from the Centers for Medicare and Medicaid Services.
Those penalties come through the 鈥淗ospital-Acquired Condition Reduction Program鈥� or HACRP, which directs the federal government to penalize a quarter of U.S. hospitals with the highest rates of those complications. The penalty is that Medicare reimburses those hospitals 1% less than normal.
Some think the penalty isn鈥檛 enough, while others think it鈥檚 unfair to hospitals that keep better records or serve sicker patients.
鈥淭he program uses measures that have documented biases in the measurement and methodology,鈥� Atul Grover, the executive vice president of the Association of American Medical Colleges, said in a statement. 鈥淭hese issues include the inability to fully risk adjust for institutions such as major teaching hospitals, which have patients who are sicker and are more likely to have multiple chronic illnesses.鈥�
is a healthcare consultant and author who鈥檚 hospital transparency. He said these kinds of lists can be unfair, but 鈥渏ust because you are trying your best to do what鈥檚 best for patients, just because you鈥檙e caring, just because you believe you鈥檙e doing what鈥檚 best doesn鈥檛 mean that you鈥檙e really carrying out things in the best possible way.鈥�
He said hospitals being penalized need to take an honest look at what more they can do to protect patients and whether they need to hire an outside consultant to help them figure out how to do better.
鈥淓ven though your folks are well-intentioned, I think having your name on this list should be a wakeup call to see whether it鈥檚 an anomaly and not fair, or whether it might be fairer than you think,鈥� he said. 鈥淚鈥檝e never seen a hospital that鈥檚 raised its hand and put out a press release and said, 鈥榊ou know what? We have a real problem here, thanks for bringing it to public attention.鈥欌��
Millenson said that patients can do their part, too, and if they鈥檙e going to a hospital on this list, 鈥測ou ask about the infection rate. You ask about whether or not people are taking certain precautions.鈥�
However, he said that鈥檚 not always helpful in rural areas where people often rely on relationships with their one hospital in town.
鈥淭he idea that consumers are going to drive change is wishful thinking,鈥� he said. 鈥淵ou are very dependent on your doctor, you鈥檙e dependent on your hospital. You might be reluctant to ask questions.鈥�
A Center for Medicare and Medicaid Services spokesperson said in a statement that hospitals on this list are already seeing the payment reduction, and it, 鈥渁pplies to all Medicare fee-for-service discharges between October 1, 2019, and September 30, 2020 (i.e., fiscal year 2020).鈥�
Kaiser Health 暗黑爆料 has put together its own so people can search which hospitals in their area have been penalized and over which years. It also shows penalties for hospitals that have 鈥渆xcessively high鈥� readmission rates under a separate Affordable Care Act program. You can look at that . Find reporter Madelyn Beck on Twitter
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This story was produced by the Mountain West 暗黑爆料 Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, KUER in Salt Lake City, KUNR in Nevada, the O鈥機onnor Center for the Rocky Mountain West in Montana, and KRCC and KUNC in Colorado.
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