Medicare nonpayment policies for certain hospital-acquired infections (HAIs) pushed hospitals to increase surveillance and prevention efforts, according to a study in the America Journal of Infection Control.
CMS in 2008 stopped providing additional payments to hospitals for treating certain HAIs, including catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections, and some forms of surgical site infections.
Policy boosts prevention efforts for certain HAIs
To assess the impact of the policy, Harvard Pilgrim Health Care Institute and Harvard Medical School researchers surveyed head infection preventionists at more than 300 U.S. hospitals.
Altogether, 81% of the surveyed preventionists reported increased focus on HAIs covered by the 2008 policy, noting a particularly strong focus on CAUTIs.
Moreover, the survey found that:
- 71% of the preventionists felt that staff members remove urinary catheters more quickly than before;
- 50% felt that staff members remove central venous catheters more quickly; and
- 56% reporting increased use of antiseptic-containing dressings for central venous catheters.
Despite the increased attention to HAIs following the nonpayment policy, only 15% of preventionists reported an increase in funding for infection control. However, 57% said their hospital's infection control team had developed strong working relationships with teams dedicated to quality improvement, and 67% reporting greater hospital collaboration through interdisciplinary teams to reduce HAI rates.
Policy's unintended consequences
The study notes that the policy had several unintended effects. For example, about one-third of the surveyed preventionists said their hospitals had shifted resources away from HAIs not covered by the 2008 nonpayment policy, instead focusing those resources on HAIs covered by the policy.
In addition, about 25% of the preventionists said their hospitals performed unnecessary tests when admitting patients to avoid financial penalties.
The researchers conclude that the nonpayment policy "appears to have had a positive impact on hospital infection prevention efforts, yet careful consideration of the potential for unintended consequences is warranted" (McKinney, Modern Healthcare, 4/30 [subscription required]; Infection Control Today, 4/30).