Three Emory-affiliated hospitals are being fined for high rates of hospital-acquired conditions (HAC) — undesirable conditions such as infections or injuries acquired from receiving hospital treatments — under the Affordable Care Act’s Hospital-Acquired Condition Reduction Program (HACRP) for fiscal year 2017.
Emory University Hospital Midtown (EUHM) is being fined for the third consecutive fiscal year, and Emory Johns Creek Hospital (EJCH) for the second consecutive fiscal year. Emory University Hospital (EUH) is being fined for a second fiscal year, the first instance occurring in 2015.
The penalized Emory-affiliated hospitals will lose 1 percent of their Medicare payments from October 2016 to September 2017 under HACRP, which was implemented in 2014 to decrease avoidable patient injuries in hospitals. HACs include blood incompatibility reactions, falls, surgical site infections and foreign objects retained after surgeries, according to the Centers for Medicare and Medicaid Services (CMS).
The 1 percent fine will reduce the amount of money penalized hospitals can spend on care for low-income people and education of their medical residents, Kaiser Health News reported.
For fiscal year 2017, CMS scored hospitals on a scale from one to 10 based on data from 2015-2017 assessing six different quality measures related to HACs, including infection rates and patient safety. Lower scores indicated better patient safety, and any hospital that obtained a HAC score greater than 6.5700 — scores in the bottom quartile of data for fiscal year 2017 — had its Medicare payments reduced by 1 percent.
Director of Media Relations of Emory Healthcare Janet Christenbury wrote in a statement to the Wheel that the ratings inaccurately compared hospitals because they are “based on methodologies that often do not sufficiently take into account the differences in patient populations and the complexity of conditions that certain hospitals treat.”
EUH received a HAC score of 7.4, EJCH received 6.81 and EUH Midtown received 8.3. Nationwide, 769 hospitals were penalized under the HACRP for the 2017 fiscal year. The nationwide average HAC score for the fiscal year was 5.206.
Teaching hospitals, such as Emory’s Midtown facility, are unique because they conduct various common and complex procedures and provide clinical education and training to current and future medical providers, Christenbury said. Consequently, there is more data to report to CMS in comparison to other facilities that treat patients with limited specializations or more common conditions, Christenbury added.
Kaiser Health News reported that the Association of American Medical Colleges estimated that nationwide, hospitals will lose a total of $430 million from the penalties.
Although Christenbury’s statement did not specify whether the Emory-affiliated hospitals have a plan to lower the penalized Emory-affiliated hospitals’ HAC scores, she said Emory Healthcare “will continue to focus on delivering high quality care to patients that results in optimal outcomes.”
Christenbury declined to comment further on the penalties.
President-elect Donald J. Trump has declared a new plan to repeal and replace the Affordable Care Act when his nominee for Secretary of Health and Human Services, former Emory professor and current Sen. Tom Price (R-Ga.), is confirmed.