![]() Only 15% of hospitals were eligible for penalties across all four years. ResultsĬomparing hospital penalty status based on various HACRP scoring methodologies over time, we found a significant overlap between penalized hospitals when using FY 20 scoring methodologies (95%) and between FY 20 methodologies (46%), but substantial differences across early vs later years. To isolate the impact of changes in scoring methods over time, we used FY2018 hospital performance data to calculate total HAC scores using FY2015 through FY2018 CMS scoring methodologies. We used hospital discharge records from 14 states to evaluate the association between changes in HACRP scoring methodology and corresponding shifts in penalty status. The sensitivity of the HACRP penalties to updates in the program’s scoring methodology has not been independently evaluated. ![]() We posit that some of this disconnect may be driven by frequent scoring updates. While early evaluations of the HACRP program reported cumulative reductions in hospital-acquired conditions, more recent studies have not found a clear association between receipt of the HACRP penalty and hospital quality of care. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Program (HACRP). Outcomes: HF, PN, MI, 30-day mortality, CLABSI, and PSI-90.Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S.Patient Experience: a subset of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey questions.Clinical Process: selected heart failure (HF), pneumonia (PN), myocardial infarction (MI), and surgical care measures.For the years noted above, the VBP program metrics are as follows: Unlike the HACRP and the Hospital Readmissions Reduction Program, which are pure penalty programs, VBP has hospitals at risk for 1.5% (for 2015) of Medicare payments, but they may earn back some, all, or an amount in excess of the 1.5% based on performance. See Table 1 for a breakdown of the program for the next two years. ![]() The Hospital VBP program continues to evolve. The report noted that reductions in adverse drug events and pressure ulcers were the largest contributors to a reported 50,000 fewer in-hospital deaths over the 2010-2013 period. Hospital-acquired conditions are defined somewhat differently in the PfP than in the HACRP, with PfP targeting certain hospital-acquired infections, pressure ulcers, falls, and adverse drug effects. declined 9% over a one-year period (2012 to 2013) and 17% over a three-year period (2010 to 2013). The agency reported that the number of hospital-acquired conditions in the Partnership for Patients (PfP) program in the U.S. hospitals and their performance in the HACRP and the Hospital Value-Based Purchasing (VBP) program is available at Just two weeks prior to the CMS announcement, AHRQ announced some major accomplishments in efforts to address patient safety at U.S. The 65% weight domain will change in FY16 with the addition of surgical site infections (colon, hysterectomy) and in FY17 with the addition of MRSA and Clostridium difficile infections. The HACRP program, which debuted in October 2014, will continue at least through 2020. These are clinically derived metrics, currently central line-associated blood stream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). 65%, CDC National Health Safety Network measures.This is a composite of eight claims-based harm measures. 35%, Agency for Healthcare Research and Quality Patient Safety Indicators (PSI-90).The HACRP is divided into the following domains: 1, 2014, as part of the Hospital-Acquired Condition Reduction Program (HACRP). hospitals-the lowest quartile-will have 1% of their reimbursement docked effective Oct. 17, 2014, the Centers for Medicare and Medicaid Services (CMS) announced that 724 U.S. In a format similar to the one used by Nursing Home Compare, the website will use a five-star rating system based on the 11 publicly reported HCAHPS measures. The CMS Hospital Compare website will debut ‘star ratings’ in April 2015 to make it easier for consumers to decipher the site’s information.
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