A study published in the New England Journal of Medicine suggests the 2008 federal non-payment policy for healthcare-acquired conditions such a central catheter-associated bloodstream infections did not have any effect on infection rates.
For the study, researchers analyzed data reported by 1,166 hospitals to the CDC's National Healthcare Safety Network before October 2008, when CMS' non-payment policy went into effect. In addition, researchers relied on data from the American Hospital Association's annual survey and from mandatory state healthcare reporting programs to determine infection rates in 2009 and beyond.
When researchers graphed the effect of the 2008 non-payment policy on hospital infection rates, they found no visible change. In fact, researchers found rates for central catheter-associated bloodstream, catheter-associated urinary tract infections and ventilator-associated pneumonia decline before the non-payment policy was implemented.
Researchers took their analysis one step further and measured the effect of the 2008 non-payment policy on hospitals with and without preexisting state mandatory infection reporting programs. They found no significant change in infection rates when the policy was implemented for both groups of hospitals.
The researchers concluded that nonpayment or financial disincentives may not effectively reduce infection rates. "As CMS continues to expand this policy to cover Medicaid through the Affordable Care Act, require public reporting of NHSN data through the Hospital Compare website and impose greater financial penalties on hospitals that perform poorly on these measures, careful evaluation is needed to determine when these programs work, when they have unintended consequences and what might be done to improve patient outcomes," they said.
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For the study, researchers analyzed data reported by 1,166 hospitals to the CDC's National Healthcare Safety Network before October 2008, when CMS' non-payment policy went into effect. In addition, researchers relied on data from the American Hospital Association's annual survey and from mandatory state healthcare reporting programs to determine infection rates in 2009 and beyond.
When researchers graphed the effect of the 2008 non-payment policy on hospital infection rates, they found no visible change. In fact, researchers found rates for central catheter-associated bloodstream, catheter-associated urinary tract infections and ventilator-associated pneumonia decline before the non-payment policy was implemented.
Researchers took their analysis one step further and measured the effect of the 2008 non-payment policy on hospitals with and without preexisting state mandatory infection reporting programs. They found no significant change in infection rates when the policy was implemented for both groups of hospitals.
The researchers concluded that nonpayment or financial disincentives may not effectively reduce infection rates. "As CMS continues to expand this policy to cover Medicaid through the Affordable Care Act, require public reporting of NHSN data through the Hospital Compare website and impose greater financial penalties on hospitals that perform poorly on these measures, careful evaluation is needed to determine when these programs work, when they have unintended consequences and what might be done to improve patient outcomes," they said.
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