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HAC Reduction Program Penalty Kicks in for FY2015

Concerns relating to program include overlap between two measures used to calculate HAC score

TUESDAY, Aug. 11, 2015 (HealthDay News) — The latest Centers for Medicare & Medicaid Services (CMS) effort to reduce hospital-acquired conditions (HACs) is the HAC Reduction Program, according to an Aug. 6 health policy brief published in Health Affairs.

The policy brief provides an overview of the program, which reduces Medicare payments by 1 percent for the poorest-performing hospitals on quality measures that track specific preventable HACs. The penalty applies to the total Medicare payment, including payments for other policy purposes.

HACs can result in longer hospital stays, permanent harm to patients, and death, and their treatment requires additional interventions that were not part of the planned care, leading to increased spending. For fiscal year 2015, 724 hospitals are subject to the HAC Reduction Program penalty; hospitals with certain characteristics are more likely to be affected by the penalty such as urban teaching hospitals. Furthermore, the penalty applies regardless of whether the hospital’s performance is improving. The total HAC score is calculated using two domains: the Patient Safety Indicator-90 composite measure and two National Healthcare Safety Network measures related to specific infections. These measures overlap with each other and with other quality programs.

“Under the law, up to 25 percent of hospitals will be subject to the HAC penalty, but which hospitals are affected may change over time for multiple reasons,” the authors write.

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