CMS Reimbursement Policy Changes Looming
In October, the Centers for Medicare and Medicaid Services (CMS) will no longer provide reimbursement over and above the typical Inpatient Prospective Payment System rate for care required to battle several types of healthcare-associated infections, including:
1. Foreign object retained after surgery
2. Air embolism
3. Blood incompatibility
4. Stage iii and iv pressure ulcers
5. Falls and trauma
6. Catheter-associated urinary tract infection
7. Vascular catheter-associated infection
8. Surgical site infection-mediastinitis after coronary artery bypass graft
9. Surgical-site infections following certain orthopedic and bariatric surgeries
10. Certain manifestations of poor control of blood sugar levels
11. Deep-vein thrombosis or pulmonary embolism following total knee and hip replacements
Not reimbursing for this mix of hospital-acquired infections and National Quality Forum-endorsed “never events” are expected to save Medicare about $20 million a year.
I suppose that’s good news for us taxpayers, but not so good news for hospitals who are struggling with quality issues and those who serve a lot of Medicare patients. Not that hospitals shouldn’t be trying to do better (they should!), but improvement doesn’t always come easy. It takes hard work and commitment.
Of all these conditions, there is good evidence to support that the design of the built environment can help reduce falls and trauma by providing good views of the patient, better pathways to the toilet, etc. Creating less noisy, less cluttered workspaces also reduces stress on staff and can help eliminate errors during surgery or other routine procedures that are in the list. The evidence linking these outcomes to the design of the built environment is not quite as strong, but doesn’t it make sense for hospitals to consider everything that can be done to improve quality? And everything includes the built environment.
September 17th, 2008 at 5:21 am
“I suppose that’s good news for us taxpayers, but not so good news for hospitals who are struggling with quality issues…”
We have an administration that values tax reduction above all else. I’m not surprised to see healthcare quality sacrificed in the name of lower taxes.
I wonder when the American people will wake up and realize that the only answer is Universal Health Care. Our healthcare delivery system is broken. VERY broken. This was explained well by Ian Morrison at the HealthCare Design conference in 2006. Here is a post on my blog about his talk:
http://www.healthcarefineart.com/2007/04/the_future_of_h.html
Americans would be wise to look around to explore alternative ways to deliver healthcare. They might be surprised to learn that all other developed nations on earth offer Universal Health Care. And, they offer better quality for a lower cost.