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Hospitals profit when patients develop bloodstream infections
Date:5/22/2013

reat. Insurers generally pay most hospitals a predetermined amount for a typical patient's stay, based on the average cost of providing care to a patient in a similar condition. The payment is set under a diagnostic related group (DRG) that pays a hospital a lump sum for a given patient's episode of care, a system which incentivizes hospitals to reduce costs of each stay since their revenues are fixed and they can keep any money that goes unspent. However, some cases are more complicated and therefore more costly to treat and insurers are required to pay more for these cases, using a mechanism known as outlier payments, in which hospitals are paid as a percentage of charges. The more the hospital charges, the more it is reimbursed by its insurer.

The majority of CLABSIs in the study were considered outliers and ensured a large payout, he adds. Private insurers pay more than government insurers for outliers, even when the triggering event was a preventable complication.

"The current payment system perversely penalizes hospitals with fewer infections," Hsu says. "What should happen instead is that hospitals should be financially rewarded for preventing harm rather than for treating the resulting illness."

Pronovost says that if private insurers took the money they spent on one preventable infection and invested it in quality improvement programs, they could see huge returns. "Given that the current policy of trying to improve quality though financial incentives has had limited impact, insurers should consider directly supporting these types of programs," he says.

Years ago, Johns Hopkins researchers, led by Pronovost, developed a much-heralded checklist and other interventions tested at The Johns Hopkins Hospital in Baltimore, and then adopted by hospitals in entire states such as Michigan and Rhode Island, that virtually eliminated catheter infections.

"More than 1,200 hospitals have significantly reduced these infection
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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