Starting Oct. 1, 2016, CMS intends to include MRSA rates in its algorithm to determine value-based purchasing incentives.
Surely time will tell whether states will rush to change their laws in light of this new study. But Wright worries that might not be such good thing. Universal decolonization has some downsides, one of which is development of MRSA strains that resist mupirocin.
That's why his hospital no longer uses that strategy. Instead, it screens patients based on an electronic health record assessment of those at highest risk, which turns out to be 50% of all of its admissions, as well as all patients admitted to the ICU to comply with state law.
Rates at NorthShore's four hospitals are even better than what was published in the NEJM paper, he says. "We haven't done a formal analysis, but when I, our infectious disease physician and hospital epidemiologist looked at this study results, we said, we're not going to do this because we're doing better than they are."
Wright is concerned, however, that state legislatures will overreact. "The thing I'm going to go to bed worrying about tonight is the well-intentioned, well-meaning legislator who is sitting in front of a computer right now with a Word document open."