ERC hospital Medicare hospital-acquired condition penalties getting worse

January 4, 2017

This year 176 hospitals in the CSG-ERC region will be penalized by Medicare for poor rates of Hospital-Acquired Conditions, potentially avoidable health problems, up by 30 from two years ago according to an analysis by Kaiser Health News. Fifty-three hospitals in the region have been penalized for each of the last three years, since the program began. Connecticut has the highest rate of hospitals penalized for all three years at 22.6%; Maryland, Vermont, Puerto Rico and the Virgin Islands have had no hospitals penalized for all three years. The penalties are based on the rate of patients with conditions such as blood clots, falls or bed sores, and for the first time since beginning the quality program, Medicare included antibiotic-resistant infections in the calculations. The CDC estimates that 23,000 Americans die each year of antibiotic resistant bacterial infections they got in a hospital. Hospitals penalized this year will lose 1% of all Medicare payments for the year that began in October. A recent study found that a similar Medicare quality improvement program – the Hospital Readmission Reduction Program – improved performance in all but one state, especially among the lowest performing hospitals. In 2015 alone, nationally readmissions were reduced by 100,000 from 2010 levels.


Hospitals with avoidable complication penalties all three years
Penalized hospitals Total hospitals %
CT 7 31 22.6%
DE 1 7 14.3%
MA 6 64 9.4%
MD 0 49 0.0%
ME 2 33 6.1%
NH 2 20 10.0%
NJ 6 66 9.1%
NY 19 172 11.0%
PA 9 169 5.3%
PR 0 52 0.0%
RI 1 11 9.1%
VI 0 2 0.0%
VT 0 14 0.0%


You might also be interested in