Using administrative data, which has been done in the past, "gets it right about one in four times," Pronovost says. "It's hard for me to think of any industry that would tolerate not being paid on a system that's wrong more than it's right."
Currently, hospitals providing this information are rewarded with a pay for reporting incentive of 2% of their Medicare reimbursement. Although about two dozen state health departments require hospital CLABSI reporting in their states, only a handful publish the data for public review.
Foster says that it's only a matter of time—perhaps just a year or two—that CLABSI, as well as catheter-associated urinary tract and surgical site infections will be not just reported to the CDC and CMS. Soon, hospitals with high rates will see their federal reimbursement checks reduced.
That's what's called for in Section 3008 of the Affordable Care Act, which imposes a 1% payment adjustment for hospitals with higher hospital-acquired infection rates for "discharges from an applicable hospital occurring during fiscal year 2015 or a subsequent fiscal year."
Foster says that most of the nation's hospitals are not waiting. "They're collecting this information themselves, getting their own data,—and knowing what is achievable, they can inform their own infection control processes."
So Pronovost, who 18 months ago called CLABSI prevention efforts like "the polio campaign for the 21st century, should go ahead and celebrate. "This is a triumph for patients, a triumph for science, and hopefully a triumph for the U.S. healthcare system," he told me.