MMMC-Clare one of 27 hospitals penalized by CMS

December 29, 2016

Mid Michigan Medical Center- Clare is one of the 27 Michigan hospitals name in the report.

Mid Michigan Medical Center- Clare is one of the 27 Michigan hospitals name in the report.

MidMichigan Medical Center – Clare and Sparrow Carson City Hospital were two of 27 penalized Michigan hospitals named in a report last week by Kaiser Health News.

A website release said, “The Economic Alliance for Michigan (EAM) is concerned about the increase in Michigan hospitals being penalized for hospital acquired conditions by the Centers of Medicare and Medicaid Services (CMS).”

The KHS report said, “The federal government has cut payments to 769 hospitals with high rates of patient injuries, and for the first time is counting the spread of antibiotic-resistant germs in assessing those penalties.”

“The punishments come in the third year of Medicare penalties for hospitals with patients most frequently suffering from potentially avoidable complications, including various types of infections, blood clots, bed sores and falls. This year the government also examined the prevalence of two types of bacteria impervious to drugs.”

The report continued, “Based on rates of all these complications, the hospitals identified by federal officials this week will lose 1 percent of all Medicare payments for a year — with that time frame beginning this past October.  While the government did not release the dollar amount of the penalties, they will exceed a million dollars for many larger hospitals. In total, hospitals will lose about $430 million, 18 percent more than they lost last year, according to an estimate from the Association of American Medical Colleges.”

The reductions apply not only to patient stays but also will reduce the amount of money hospitals get to teach medical residents and care for low-income people.

Penalized hospitals will lose 1 percent of Medicare payments for a year. Estimated losses among larger hospitals will exceed $1 million, according to the report.

Forty percent of the hospitals penalized this year escaped punishment in the first two years of the program, a Kaiser Health News analysis shows. Those 306 hospitals include the University of Miami Hospital in Florida, Cambridge Health Alliance in Massachusetts, the University of Michigan Health System in Ann Arbor and Mount Sinai Hospital in New York City.

Each year, at least 2 million people become infected with bacteria that are resistant to antibiotics, including nearly a quarter million cases in hospitals. The Centers for Disease Control and Prevention estimates 23,000 people die from them.

One resistant bacteria that Medicare included into its formula for determining financial penalties for hospitals is methicillin-resistant Staphylococcus aureus, or MRSA, which can cause pneumonia and bloodstream and skin infections. 

The second bacteria measured for the penalties is Clostridium difficile, known as C. diff, a germ that can multiply in the gut and colon when patients take some antibiotics to kill off other germs. It can also spread through contaminated surfaces or hands.
“The reality is we don’t know how to prevent all these infections,” said Dr. Louise Dembry, a professor at the Yale School of Medicine and president of the Society for Healthcare Epidemiology of America.

The Affordable Care Act requires that Medicare penalize the 25 percent of hospitals (except specialized hospitals like those that treat psychiatric patients, veterans and children) that perform the worst on these measures, even if they have reduced infection rates from previous years.

That inflexible quota is one objection the hospital industry has with the penalties. In addition, many hospitals complain that they are penalized because of their vigilance in detecting infections, even ones that do not cause any symptoms in patients. Academic medical centers in particular have been frequently punished.
Over the lifetime of the penalty program, 241 hospitals have been punished in all three years.

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