‘Passive payer’ no more: New CMS requirements will hit hospital budgets

January 12th, 2015

A broad array of new federal regulations on health care associated infections (HAIs) will continue to come on line in 2014 and beyond, tying infection prevention more directly to the hospital bottom line than at any time in the field’s history.

“In the past, hospitals had little financial incentive to improve the quality of their care because Medicare and other purchasers paid hospitals for treating infections or errors even when they could have been prevented,” said Patrick Conway, MD, director of the Center for Clinical Standards and Quality at the Centers for Medicare and Medicaid (CMS).

“Now, Medicare, state Medicaid programs, and many private sector health plans and purchasers, are moving rapidly to change payment systems to reward better outcomes instead of volume of services. CMS is working to transform from a passive payer to an active purchaser of higher-value health care services,” he said at a recent Congressional Hearing on HAIs.

Conway outlined a number of federal initiatives that are creating strong financial incentives for hospitals to prevent infections and medical errors. Some of the provisions continue to come on line as part of the Affordable Care Act, with the CMS requiring many of its measures to be reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) and ultimately publicly posted on the CMS Hospital Compare site.

For full details on this important story see the January 2014 issue of Hospital Infection Control & Prevention