Effect of Medicare’s Nonpayment Program on HACs

Editor's Note

Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a declined in the incidence of selected HACs, and the decline was greater in hospitals with a higher Medicare utilization ratio (MUR), this study finds.

Of 867,584 Medicare patients analyzed, the program was associated with a decline in incidence of the (i) any-or-none indicator for occurrence of at least 1 of 6 HACs in MUR quartile 2 hospitals and (ii) catheter-associated urinary tract infections in MUR quartile 3 hospitals, compared with quartile 1 hospitals.

There also were significant declines in certain HACs in the stratified analysis.

Background: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program.