Fall 2006
Vol. 16, Number 3

IDSA and other professional societies are urging Medicare officials not to withhold higher payments from hospitals that implement evidence-based health care-associated infection prevention practices.

As part of Medicare’s move toward “value-based purchasing,” the agency is using financial incentives to achieve quality and efficiency goals. Under federal law, the Centers for Medicare and Medicaid Services (CMS) is required to identify at least two common or costly hospital complications that could have been prevented through the application of evidence-based guidelines. For discharges occurring on or after Oct. 1, 2008, hospitals would not receive additional payment for patients who had not been diagnosed with that complication on admission. Most of the discussion about how to implement this law has focused on hospital-acquired infections (HAI).

IDSA, the Society for Healthcare Epidemiology of America (SHEA), and the Association for Professionals in Infection Control and Epidemiology (APIC) this summer submitted comments to CMS. Although the three groups support efforts to reward hospitals that strive to prevent HAIs, the APIC-SHEA-IDSA letter pointed out that not all hospital infections are preventable. In fact, HAIs can occur despite near-complete adherence to high-quality,validated processes of care, the letter said.

In addition, the groups note it is very difficult to distinguish between HAIs and community-acquired infections. Community-acquired infections often cannot be diagnosed on admission and thus are not included as a secondary diagnosis at the time of admission. Many groups are concerned that hospitals that take care of sicker, more complex patients could be unfairly penalized.

CMS has promised to work with the Centers for Disease Control and Prevention to select the conditions to implement the law. Professional societies will have another opportunity to comment on the draft measure next spring. See future issues of IDSA News for updates.