The federal government is cracking down on half a dozen Maine hospitals, including The Aroostook Medical Center, for high rates of complications and infections.
The six Maine facilities are among 721 hospitals nationally with high rates of infections and other patient injuries that will see their payments cut under the federal Medicare program, according to an analysis by Kaiser Health News. The crackdown is the government’s toughest effort to date aimed at reducing avoidable medical errors.
Medicare will cut payments to the hospitals by 1 percent over the fiscal year that began Oct. 1 and ends in September 2015. The federal Centers for Medicare and Medicaid Services in June released a preliminary list of hospitals likely to face penalties, followed by a confirmed list on Dec. 18.
The penalties, estimated to total $373 million nationally, will hit academic medical centers particularly hard, with about half punished, Kaiser found. Hospitals that treat a high volume of low-income patients also are more likely to be assessed penalties, as are large hospitals and those located in cities.
The federal government looked at eight avoidable patient injuries — including blood clots, bed sores, accidental falls after surgery and collapsed lung — that result from medical treatment. It also examined urinary tract infections from catheters and bloodstream infections in patients who had central lines, or catheters, placed in major veins. Medicare assigned each hospital a score on a scale of 1 to 10. Hospitals in the top quarter — with a total score above 7 — face penalties.
About 1,400 hospitals are exempt from penalties, including small “critical access hospitals” located in rural areas. Of Maine’s 38 hospitals, 16 are critical access facilities.
Preventing infections and mistakes has become a top priority for hospitals. Preventable hospital errors are the third-leading cause of death in the U.S., claiming the lives of up to 440,000 patients per year, according to a landmark September 2013 study published in the Journal of Patient Safety. But hospitals are making progress, with a recent federal report showing about 50,000 people are alive today because hospitals committed 17 percent fewer medical errors in 2013 than in 2010.
Hospital officials argue that facilities treating the sickest patients and those that identify infections properly may score worse.
Dr. Robert Thompson, senior vice president and chief medical officer for Eastern Maine Healthcare Systems — the parent organization to EMMC, Inland and The Aroostook Medical Center — said Medicare based the penalties on dated information, with some of it reported in 2011.
“These ratings do not reflect our present performance, and incidences of infection and injury at EMHS have declined since this data was initially released last spring,” he said in a statement. “EMHS takes all potential harm seriously. We are continually seeking to improve through partnership with our doctors, nurses, health care workers, and our patients and families across our region.”
TAMC officials also weighed in on the survey.
“Any infection or injury is one too many,” said Dr. Jay Reynolds, TAMC chief medical officer and chief clinical officer. “At TAMC we believe that when it comes to patient safety, no number is an acceptable number. Certainly, we are disappointed to be on the list. This ranking reflects older data that goes back to 2011.
“We have a rigorous program already in place to ensure our patients receive the safest care possible. That has included the restructuring of our quality department, development of a new quality committee, the addition of the only two infectious disease specialists north of Bangor to our team of physicians, the board certification of our infection control manager, and other initiatives,” he added.
“We understand that there is always room for improvement and use information like this to advance our work to continuously improve patient safety and the overall patient experience. At the same time we are pleased to be recently recognized for excellence by Medicare and others. As we receive this report we also learn that TAMC will be among the hospitals to get a bonus in the coming year under Medicare’s value-based purchasing program. That payment is based on patient experiences, outcomes, clinical processes and more. This program was established in 2012 to reimburse hospitals for quality,” Reynolds said.
“We were also just recently recognized by the Joint Commission as a 2013 Top Performer on Key Quality Measures and were the only hospital north of Augusta to be recognized in all four measurements for attaining and sustaining excellence in accountability measure performance for heart attack, heart failure, pneumonia, and surgical care,” he added.
