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Arntson E, Dimick JB, Nuliyalu U, et al. Ann Surg. 2021;274(4):e301-e307.
Hospital-acquired conditions (HACs) are thought to be preventable, and the Centers for Medicare & Medicaid Services (CMS) reduce payments to hospitals with the highest rates of these conditions through its Hospital-Acquired Condition Reduction Program (HACRP). This study evaluated surgical HACs at three timepoints: before Affordable Care Act (ACA) implementation, after ACA implementation, and after HACRP. While the number of HACs continued to decline after implementation of HACRP, it did not affect 30-day mortality.
Rockville, MD: Agency for Healthcare Research and Quality; July 7 2021.
Health care–associated infections occur across various health care settings. AHRQ seeks to support large research (R01) and dissemination (R18) projects working to develop strategies and approaches for preventing and reducing health care–associated infections. Applications will be accepted on a standard submission schedule through May 27, 2025.
Rockville, MD: Agency for Healthcare Research and Quality. PA-21-266.
This funding opportunity will support collaborative learning strategies that enable individuals and organizations to employ rapid prototyping to engineer new approaches focused on improving diagnosis and treatment. This learning laboratory funding builds on prior initiatives to further improvements in patient safety. The project submission process will close January 27, 2023.
Holm S, Stanton C, Bartlett B. Health Care Anal. 2021;29(3):171-188.
Artificial intelligence (AI) is currently used to assist with many healthcare practices, including diagnosing cancer, detecting deterioration, and medication reconciliations. As the use of AI continues to expand, regulators and legal experts will need to consider how to manage compensation for patients who have experienced medical errors. This commentary suggests no-fault compensation as a possible solution. 
Johnson SM, Samulski TD, O’Connor SM, et al. Am J Clin Pathol. 2021;156(4):559-568.
Newly diagnosed cancer patients may request second opinions to confirm diagnosis, treatment, or prognosis. This study evaluated the pathology-specific reimbursement for cases originating at the primary site, a comprehensive cancer center, and cases originating at affiliate sites and referred to the cancer center for second opinions. Results confirmed that second opinions can reduce diagnostic errors and potentially lower costs of subsequent treatment; however, ways to improve the cost and process of receiving a second opinion should be explored.
D’Amore JD, McCrary LK, Denson J, et al. J Am Med Inform Assoc. 2021;28(7):1534-1542.
Quality measurement is increasingly being incorporated into policies outlining healthcare provider reimbursement. This study compared quality measure calculations between an individual electronic health record (EHR) source and the same EHR source combined with health information exchange (HIE) data. The results show that adding HIE data changed 15% of quality measure calculations. The authors suggest that incorporating HIE data into reimbursement programs could promote more accurate and representative quality measurement.
Vsevolozhskaya OA, Manz KC, Zephyr PM, et al. BMC Health Serv Res. 2021;21(1):131.
Since 2014, Medicare’s Hospital-Acquired Condition Reduction Program (HACRP) reduces payments to hospitals with elevated rates of certain conditions. Based on multistate data, the authors conclude that there is a disconnect between penalties levied by the program and hospital performance, suggesting that the program may not drive patient safety improvements as intended.  

Jaffe S. Medpage Today. November 25, 2020.

Infection control is a primary safety mechanism that presents challenges for nursing homes. This news story highlights a Centers for Medicare and Medicaid Services program to fine nursing homes for infection control lapses during the COVID pandemic and discusses the potential residual impacts of the strategy.

Garman AN, McAlearney AS, Harrison MI, et al. Health Care Manag Rev. 2011-2020.

In this continuing series, high-performance work practices are explored and defined through literature review, case analysis, and research. The authors summarize findings and discuss how best practices can influence quality, safety, and efficiency outcomes. Topics covered include speaking up, central line infection prevention, and business case development.

Rau J. Kaiser Health News. January 30, 2020.

Medicare reimbursement restrictions are a controversial stimulus to motivate hospital acquired condition reduction efforts. This news article examines the legacy of the penalties, the data's ability to be effectively applied across various types of institutions, and the lack of direct connection to improvements.
Sheetz KH, Dimick JB, Englesbe MJ, et al. Health Aff (Millwood). 2019;38(11):1858-1865.
Since 2013, Medicare’s Hospital-Acquired Condition Reduction Program (HACRP) has reduced payments to hospitals with elevated rates of specific outcomes deemed to be preventable sources of harm. To better understand the impact of the HACRP in Michigan, this study used a surgical registry to compare trends in rates of outcomes targeted by the program to concurrent trends for other hospital-acquired conditions, such as postoperative cardiac arrest and postoperative pneumonia. The authors saw an overall decrease in all hospital-acquired conditions over the eight-year study period but did not identify a statistically significant change in the rate of HACRP-targeted versus non-targeted conditions. The authors acknowledge that these findings may not be generalizable nationally because of robust quality improvement efforts already in place in Michigan, such as existence of other quality improvement efforts, such as the AHRQ-recognized Michigan Surgical Quality Collaborative and the Hospital Engagement Network
Rau J. New round of Medicare readmission penalties hits 2,583 hospitals. Kaiser Health News; October 1, 2019.
The federal government strategy to incentivize reductions in hospital readmissions through loss of Medicare reimbursement is controversial. This article discusses the latest set of penalties and shares concerns about the program and its ability to affect patient safety. 
Akinleye DD, McNutt L-A, Lazariu V, et al. PLoS One. 2019;14:e0219124.
The relationship between hospital financial performance and patient safety remains somewhat controversial. Although it makes intuitive sense that more financially stable hospitals should be able to invest more in improving safety, prior studies have not consistently confirmed this hypothesis. Investigators examined the relationship between financial performance and the safety and quality of care at 108 hospitals in New York State. They found that stronger financial performance was correlated with improved patient experience, lower readmission rates, and higher performance on measures of safety and quality. This finding has policy implications, as other studies have found that safety-net hospitals (which generally have lower financial margins) face more difficulties in responding to safety and quality regulations.
Wilensky GR. The Milbank Q. 2019;97(3):641-644.
High-quality, reliable safe health care is a complex challenge. This commentary reviews estimates of health care–associated harm and injury to patients and the complexities associated with the Centers for Medicare and Medicaid Services financial penalties approach to drive improvement.
Sankaran R, Sukul D, Nuliyalu U, et al. BMJ. 2019;366:l4109.
The Centers for Medicare and Medicaid Services impose financial penalties on hospitals whose Medicare patients experience higher rates of hospital-acquired conditions (HACs) like urinary tract infections and pneumonia. Hospitals caring for more patients with low socioeconomic status receive more penalties under this program than hospitals caring for wealthier populations. Investigators attempted to assess whether hospitals penalized under the program reduced HAC rates. They found that penalized hospitals did not have lower HAC rates or improve other measures of clinical quality. This finding raises questions about whether financial penalties effectively enhance patient safety. By contrast, quality improvement collaboratives like Partnership for Patients have markedly reduced HACs. A PSNet interview with former AHRQ director Andrew Bindman explored strategies for reducing health care–acquired harm in the hospital and ambulatory settings.
Rau J. Kaiser Health News. March 1, 2019.
Financial incentives may encourage adoption of practice improvements that enhance safety. This news article reports on the increase in United States hospitals that have had Medicare payments withheld due to high rates of hospital-acquired conditions. The article is accompanied by a state-level tally of individual hospitals penalized.