Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: Retrospective cohort study

The BMJ

Volumn 366, Issue , 2019, Pages

  Sankaran, Roshun ^a,b   Sukul, Devraj ^b   Nuliyalu, Ushapoorna ^a,c   Gulseren, Baris ^a   Engler, Tedi A ^a,c   Arntson, Emily ^a,b   Zlotnick, Hanna ^a   Dimick, Justin B ^a,b,c   Ryan, Andrew M ^a,c  

^a UNIVERSITY OF MICHIGAN   (United States)

^b UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^c Department of Surgery Division of Colorectal Surgery Center for Healthcare Outcomes and Policy   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; COHORT ANALYSIS; CONTROLLED STUDY; EMERGENCY CARE; FEMALE; HOSPITAL READMISSION; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICARE; MORTALITY; OUTCOME ASSESSMENT; PUNISHMENT; RETROSPECTIVE STUDY; SOCIAL STATUS; TEACHING; GOVERNMENT; HEALTH CARE QUALITY; HOSPITAL; IATROGENIC DISEASE; PATIENT SAFETY; PROGRAM EVALUATION; REIMBURSEMENT; STANDARDS; STATISTICS AND NUMERICAL DATA; UNITED STATES;

CENTERS FOR MEDICARE AND MEDICAID SERVICES (U.S.); HOSPITALS; HUMANS; IATROGENIC DISEASE; INSURANCE, HEALTH, REIMBURSEMENT; MEDICARE; PATIENT READMISSION; PATIENT SAFETY; PROGRAM EVALUATION; QUALITY INDICATORS, HEALTH CARE; RETROSPECTIVE STUDIES; UNITED STATES;

EID: 85068529625     PISSN: 09598146     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.l4109     Document Type: Article

References (37)

1. Agency for Healthcare Research and Quality. 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy. 2016. https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/nhqdr15/2015nhqdr.pdf
2. Hsu E, Lin D, Evans SJ, et al. Doing well by doing good: assessing the cost savings of an intervention to reduce central lineassociated bloodstream infections in a Hawaii hospital. Am J Med Qual 2014;29:13-9. doi:10.1177/1062860613486173
3. Center for Medicare and Medicaid Services. Federal Register. Vol 79. 2014. https://www.gpo.gov/fdsys/pkg/FR-2014-10-03/pdf/2014-23630.pdf
4. Scott RD II. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. 2009. https://www.cdc.gov/hai/pdfs/hai/scott-costpaper.pdf
5. Klevens RM, Edwards JR, Richards CLJr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122:160-6. doi:10.1177/003335490712200205
6. Centers for Medicare and Medicaid Sevices. Hospital-acquired condition reductoin program fiscal year 2018 fact sheet. 2018. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Downloads/FY2018-HAC-Reduction-Program-Fact-Sheet.pdf
7. Ibrahim AM, Dimick JB, Sinha SS, Hollingsworth JM, Nuliyalu U, Ryan AM. Association of coded severity with readmission reduction after the hospital readmissions reduction program. JAMA Intern Med 2018;178:290-2. doi:10.1001/jamainternmed.2017.6148
8. Markovitz AA, Ryan AM. Pay-for-performance: disappointing results or masked heterogeneity?Med Care Res Rev 2017;74:3-78. doi:10.1177/1077558715619282
9. Rajaram R, Chung JW, Kinnier CV, et al. Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program. JAMA 2015;314:375-83. doi:10.1001/jama.2015.8609
10. Navathe AS, Liao JM, Polsky D, et al. Comparison of hospitals participating in Medicare's voluntary and mandatory orthopedic bundle programs. Health Aff (Millwood) 2018;37:854-63. doi:10.1377/hlthaff.2017.1358
11. Zuckerman RB, Sheingold SH, Orav EJ, Ruhter J, Epstein AM. Readmissions, Observation, and the Hospital Readmissions Reduction Program. N Engl J Med 2016;374:1543-51. doi:10.1056/NEJMsa1513024
12. Center for Medicare and Medicaid Services. Medicare Program-general information. 2018 [cited 2019 Mar 2]. https://www.cms.gov/Medicare/Medicare-General-Information/MedicareGenInfo/index.html
13. Centers for Medicare and Medicaid Sevices. FY 2015 final rule tables, table 17. FY2015 IPPS final rule. 2015 [cited 2018 Jun 10]. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2015-IPPS-Final-Rule-Home-Page-Items/FY2015-Final-Rule-Tables.html
14. Agency for Healthcare Research and Quality. Quality indicators software, version 6.0.2. 2016.
15. Shoag J, Halpern J, Eisner B, et al. Efficacy of prostate-specific antigen screening: Use of regression discontinuity in the plco cancer screening trial. JAMA Oncol 2015;1:984-6. doi:10.1001/jamaoncol.2015.2993
16. Moscoe E, Bor J, Bärnighausen T. Regression discontinuity designs are underutilized in medicine, epidemiology, and public health: a review of current and best practice. J Clin Epidemiol 2015;68:122-33. doi:10.1016/j.jclinepi.2014.06.021
17. Venkataramani AS, Bor J, Jena AB. Regression discontinuity designs in healthcare research. BMJ 2016;352:i1216. doi:10.1136/bmj.i1216
18. Desai S, McWilliams JM. Consequences of the 340B Drug Pricing Program. N Engl J Med 2018;378:539-48. doi:10.1056/NEJMsa1706475
19. Centers for Medicare and Medicaid Sevices. Fiscal Year 2015 results for the CMS Hospital-Acquired Condition Reduction Program and Hospital Value-Based Purchasing Program. 2014 [cited 2018 Jun 15]. https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2015-results-cms-hospital-acquired-condition-reduction-program-andhospital-value-based
20. Imbens G, Lemieux T. Regression discontinuity designs: a guide to practice. 2007. Report No: Working Paper No 13039.
21. Roberts ET, Zaslavsky AM, McWilliams JM. The value-based payment modifier: Program outcomes and implications for disparities. Ann Intern Med 2018;168:255-65. doi:10.7326/M17-1740
22. Lee DS, Lemieux T. Regression discontinuity designs in econometrics. J Econ Lit 2010;48. doi:10.1257/jel.48.2.281
23. Chay KY, McEwan PJ. The central role of noise in evaluating interventions that use test scores to rank schools. Am Econ Rev 2005;95:1237-58. doi:10.1257/0002828054825529
24. Calonico S, Cattaneo MD, Titunik R. Robust data-drive inference in the regression-discontinuity design. Stata J 2014;14:909-46. doi:10.1177/1536867X1401400413
25. de la Cuesta B, Imai K. Misunderstandings about the regression discontinuity design in the study of close elections. Annu Rev Polit Sci 2016;19:375-96. doi:10.1146/annurevpolisci-032015-010115
26. Centers for Medicare and Medicaid Sevices. Case Mix Index. [cited 2018 Jun 15]. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Acute-Inpatient-Files-for-Download-Items/CMS022630.html
27. Prasad V, Jena AB. Prespecified falsification end points: can they validate true observational associations?JAMA 2013;309:241-2. doi:10.1001/jama.2012.96867
28. Fuller RL, Goldfield NI, Averill RF, Hughes JS. Is the CMS Hospital-Acquired Condition Reduction Program a valid measure of hospital performance?Am J Med Qual 2017;32:254-60. doi:10.1177/1062860616640883
29. Doran T, Fullwood C, Kontopantelis E, Reeves D. Effect of financial incentives on inequalities in the delivery of primary clinical care in England: analysis of clinical activity indicators for the quality and outcomes framework. Lancet 2008;372:728-36. doi:10.1016/S0140-6736(08)61123-X
30. Girault A, Bellanger M, Lalloué B, Loirat P, Moisdon JC, Minvielle E. Implementing hospital pay-for-performance: Lessons learned from the French pilot program. Health Policy, 2017.
31. Milstein R, Schreyoegg J. Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries. Health Policy 2016;120:1125-40. doi:10.1016/j.healthpol.2016.08.009
32. Eijkenaar F, Emmert M, Scheppach M, Schoffski O. Effects of pay for performance in health care: a systematic review of systematic reviews. Health Policy 2013;110:115-30. doi:10.1016/j.healthpol.2013.01.008
33. Desai NR, Ross JS, Kwon JY, et al. Association between hospital penalty status under the Hospital Readmission Reduction Program and readmission rates for target and nontarget conditions. JAMA 2016;316:2647-56. doi:10.1001/jama.2016.18533
34. Press MJ, Scanlon DP, Ryan AM, et al. Limits of readmission rates in measuring hospital quality suggest the need for added metrics. Health Aff (Millwood) 2013;32:1083-91. doi:10.1377/hlthaff.2012.0518
35. PSI 90 fact sheet. Agency for Healthcare Research and Quality (AHRQ) quality indicators (QIs) fact sheet. 2016. Pages 1-8. https://www.qualityindicators.ahrq.gov/News/PSI90-Factsheet-FAQ.pdf
36. Cassidy A. Health policy brief: Medicare's Hospital-Acquired Condition Reduction Program. Health Aff 2015.
37. 114th Congress (2015-2016). HR34 21st century cures act. 2016. https://www.congress.gov/bill/114th-congress/house-bill/34/