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Journal Article > Study
Centers for Medicare and Medicaid Services hospital-acquired conditions policy for central line–associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement.
Calderwood MS, Kawai AT, Jin R, Lee GM. Infect Control Hosp Epidemiol. 2018;39:897-901.
The Centers for Medicare and Medicaid Services (CMS) nonpayment policy for health care–associated infections is widely viewed as a catalyst for infection prevention initiatives. This analysis of Medicare fee-for-service claims data shows that following nonpayment policy implementation, there was a substantial increase in claims in which central line–associated bloodstream infections and catheter-associated urinary tract infections were reported to be present on arrival to the hospital. According to this analysis, because CMS continued to reimburse hospitals for conditions present on arrival, the nonpayment policy did not have significant financial impact. The authors conclude that the nonpayment policy for health care–associated infections did not have its intended effect. A past PSNet interview discussed the potential benefits and limitations of insurers not paying for preventable complications.
Journal Article > Study
CDC central-line bloodstream infection prevention efforts produced net benefits of at least $640 million during 1990–2008.
Scott RD II, Sinkowitz-Cochran R, Wise ME, et al. Health Aff (Millwood). 2014;33:1040-1047.
Multiple national efforts focus on eliminating central line–associated bloodstream infections (CLABSIs), which are a key source of patient harm. Prior investigations have shown that although avoidance of these costly infections results in overall health care savings, hospitals may actually earn more from private payer reimbursements for patients that develop CLABSI. This study adapted a historical economic model to estimate the net benefits of preventing CLABSI in Medicare and Medicaid patients in intensive care units. From 1990 to 2008, approximately 50,000 CLABSIs were avoided in these patients, resulting in net savings ranging from $640 million to $1.8 billion for the federal government. This translates into a per dollar rate of return on Centers for Disease Control and Prevention investments between $3.88 and $23.85. These numbers may all be underestimates since only patients in intensive care units were included, and many patients with CLABSI are in other hospital wards. This study provides support for the business case for patient safety efforts.