Financial Incentives for Preventing HAIs Don't Add Up to Much

Cheryl Clark, for HealthLeaders Media , September 5, 2013

Domain two is a combination of a hospital's CLABSI and catheter-associated urinary tract infection rates or CAUTIs. Domain 2 counts 65%.

Now we could be talking real money. A hospital with higher rates of sepsis, central venous catheter, CLABSI and CAUTI infections could heavily influence whether it suffers a 1% DRG pay cut in FY 2015.

But to many hospitals leaders I've talked with recently, this may seem too away to take seriously in 2013.

For Zimlichman and his research colleagues, hospitals "must try to get accustomed with the entire emerging array of payment reforms," which he said will make major changes on how hospitals calculate their financial losses and gains.

"As we slowly phase out of fee for service payment approach, we're going to see hospitals investing much more in efforts to battle complications. There's no doubt about that."

The idea is that when payers, including private insurers and the government, start demanding that the costs of managing and fixing avoidable healthcare errors be shifted from payers to providers through bundled payments and accountable care organization contracts, hospitals will start seeing these costs on their balance sheets. And the awakening then will be rude indeed.

The Brigham & Women's study was an effort to brace hospital leaders against the shock they'll get when payment reforms are much more robust than they are today. Existing HAC penalties in current federal rules, I'm afraid to say, don't amount to much more than a hill of beans.

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