Hospital-Acquired Condition Reduction Program Is Not Associated With Additional Patient Safety Improvement

Health Aff (Millwood). 2019 Nov;38(11):1858-1865. doi: 10.1377/hlthaff.2018.05504.

Abstract

In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. Whether the program has been successful in improving patient safety has not been independently evaluated. We used clinical registry data on rates of hospital-acquired conditions in 2010-18 from a large surgical collaborative in Michigan to estimate the impact of the policy. While rates of all such conditions declined from 133.4 per 1,000 discharges in the pre-program period to 122.2 in the post-program period, greater improvements were observed for nontargeted measures. We conclude that the program did not improve patient safety in Michigan beyond existing trends. These findings raise questions about whether the program will lead to improvements in patient safety as intended.

Keywords: Diseases; Health policy; Hospital acquired conditions reduction program; Hospital quality; Medicare; Patient safety; Quality improvement; Quality of care.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Centers for Medicare and Medicaid Services, U.S.
  • Facility Regulation and Control / economics*
  • Humans
  • Iatrogenic Disease / economics*
  • Iatrogenic Disease / epidemiology
  • Iatrogenic Disease / prevention & control*
  • Incidence
  • Michigan / epidemiology
  • Patient Safety / standards*
  • Quality Improvement*
  • United States