A recent study by the New England Journal of Medicine finds no evidence that the 2008 CMS policy to reduce payments for central catheter–associated bloodstream infections and catheter-associated urinary tract infections had no measurable effect on infection rates in U.S. hospital. In October 2008, the Centers for Medicare and Medicaid Services (CMS) discontinued additional payments for certain hospital-acquired conditions that were deemed preventable. A total of 398 hospitals or health systems contributed 14,817 to 28,339 hospital unit–months, depending on the type of infection.
A study in the American Journal of Infection Control finds that the policy has led front-line hospital staff to enhance their focus on infection prevention and change their practices. But one-third of respondents said their hospitals needed to shift resources away from non-targeted infections in order to focus on targeted infections. Infection preventionists also expressed concern that hospitals focused more on improving physician documentation and coding practices to avoid negative financial penalties, rather than enhancing infection prevention efforts to improve patient outcomes. Finally, a quarter of respondents reported that their hospitals performed unnecessary diagnostic testing, upon admission, to avoid potential financial penalties. For more information, visit www.apic.org.