Medicare tightening 'quality' noose around hospitals

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Federal regulators have proposed adding nine conditions to the list of "preventable" conditions for which they will not pay hospitals.

They originally announced that starting this October, they would no longer reimburse for falls, catheter-based urinary infections, pressure ulcers and other conditions "that could reasonably have been prevented." Now, Centers for Medicare & Medicaid Services officials have proposed adding clostridium difficile-associated disease, ventilator-associated pneumonia, extreme blood-sugar derangement and six other conditions to the "no-pay" list.

While nursing homes were the first healthcare sector to be subject to public quality indicator reporting, hospitals have since surpassed them in pay-for-performance demands from the government. Nursing homes, however, will become subject to new pay-for-performance rules over the next few years, regulators have said.

This week, CMS Acting Administrator Kerry Weems also announced that 43 additional quality measures would be put into play for calculating hospitals' pay rates, giving long-term care providers provocative thoughts to mull.

"Medicare can and should take the lead in encouraging hospitals to improve the safety and quality of care and make better practices a routine part of the care they provide, not just to people with Medicare, but to every patient they treat," Weems said.