University Hospitals and Clinics and Meriter Hospital are among 65 hospitals in the state and 750 nationwide that could be penalized by Medicare in October for high rates of patient injuries and infections. According to an article in The Capital Times, the penalties are part of the third and final category of care through which hospitals will be monitored as part of the federal Affordable Care Act. The penalties are intended to improve patient safety and health outcomes.
In 2012, according to the article, one out of eight patients nationwide suffered a potentially avoidable complication during a hospital stay.
Hospitals nationwide are now scored based on patient outcomes, with zero representing the best score. Hospitals receiving a score under 7 are not penalized. St. Mary’s scored a 5.35. Meriter scored a 7.625, and UW Hospitals and Clinics, a teaching hospital that often sees very sick patients and patients transferred from other hospitals, received a score of 8.7.
UW Hospital’s fine could add up to about $1 million, which would be deducted from the hospital’s Medicare payments this fall.
Nationwide, sanctions could total as much as $330 million over a year, even though infections and accidents in hospitals are on the decline. In fact, UW Hospital and Dr. Nasia Safdar, its chief of infection control, were recognized last year for their initiatives to reduce hospital infections.
One concern is that the health law requires Medicare to punish hospitals based on the worst-performing quarter each year, even though they may have shown improvement during the rest of the year. Some in the industry are wondering if the metrics with which hospitals are being measured are correct.
