Health care reform targets hospital-acquired infections

The new federal health care reform law may bring health insurance to millions of Americans. But one if its lesser-known features, according to a national consumers group, is the law’s attempt to reduce the number of costly—and deadly—hospital-acquired infections.

In 2006, just two conditions caused by hospital-aquired infections in the U.S. (sepsis and pneumonia), were responsible for nearly 50,000 deaths and cost more than $8 billion to treat, according to a February report in the Archives of Internal Medicine.

The new act, signed into law by President Obama last month, will require more public reporting of medical errors, such as infections, at hospitals, something New Mexico does not yet fully do.

“It’s definitely a step forward,” Lisa McGiffert of Consumers Union said of the federal legislation. McGiffert leads Consumer Union’s Safe Patient Project. (Consumers Union also publishes the well-known magazine Consumer Reports.)

Safe Patient Project recently analyzed incentives and punitive measures in the new federal health care law related to hospital acquired infections and medical errors, and what it found was a carrot-and-stick approach through a series of  measures codified by Congress.

“It’s not everything we wanted,” McGiffert said. “We would have liked to see a more straightforward hospital infections report. But it will create a lot more attention on hospital acquired infections.”

Sen. Dede Feldman, D-Albuquerque, who has pushed for greater reporting of medical error and infection rates from New Mexico hospitals, was more effusive in her praise of the new law.

“What good news!” Feldman said. “This is what the federal government should be doing to increase quality and decrease cost.”

One of the provisions that should help consumers assess the quality of care at New Mexico’s hospitals is a provision that will require more public reporting of medical errors, including hospital-acquired infections.

Unlike some states, including Colorado, New Mexico doesn’t require hospitals yet to publicly report rates of hospital-acquired infections, despite the recommendations of a 2009 Healthcare-Associated Infections Advisory Committee report.

Currently more than a dozen New Mexico hospitals are voluntarily reporting incidents involving central line-associated bloodstream infections that occur at their Intensive Care Units. They are not currently required to report the incidents, however.

The lack of public disclosure, supporters of such openness say, means that New Mexicans don’t have a way to measure the quality of care they receive at the state’s medical facilities.

But for at least some cases that lack of public reporting may become moot with the new federal health care law.

Beginning in 2014, the U.S. Health and Human Services Department will report, on its Hospital Web site, each hospital’s record for medical errors and infections involving Medicare patients.

The federal law also attempts to encourage better patient outcomes through various incentives and restrictions, according to Consumers Union.

Beginning in October 2012 non-rural acute care hospitals that beat federal performance standards for at least five measures, including certain hospital-acquired infections, will receive higher Medicare payments, the organization found.

The federal government pays hospitals and other medical providers for delivering services to Medicare recipients.

Two years later in 2014, the federal government will reduce Medicare payments by one percent for those hospitals with the highest rates of medical harm as measured by “hospital-acquired conditions,” the Consumers Union reports.

Those include certain preventable infections and medical errors, such as serious bedsores, catheter-associated urinary tract infections and certain types of falls and trauma, the organization reports.

Meanwhile, the federal government will expand to Medicaid a policy of restricting payments to hospitals for extra care due to “certain preventable infections and medical errors.” Medicaid is the government’s low-income health insurance program.

The government already does that with Medicare, according to the organization.

Feldman said the new federal law would lead to real change because it does what’s needed – “and that’s change how we reimburse providers,” Feldman said.

Hospitals and other medical providers are financially reimbursed for Medicaid and Medicare services.

“They respond to reimbursement,” she said. “If they are awarded for improving, they will pay attention to that too. That is very good news. That will force change, more than any requirement.”