Effect of Medicare’s nonpayment program on HACs

Editor's Note

Medicare’s Nonpayment Program of 2008, which withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs), was associated with a decline in the incidence of selected HACs in this study. The decline was greater in hospitals with higher Medicare utilization ratios (MURs).

In this analysis of nearly 868,000 Medicare patients, the nonpayment program was associated with a decline of any-or-none indicators of at least 1 of 6 HACs in MUR quartile 2 hospitals and catheter-associated urinary tract infections in MUR quartile 3 hospitals, compared with MUR quartile 1 hospitals.

Background: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program.