Impact of the Centers for Medicare and Medicaid Services Hospital-Acquired Conditions Policy on Billing Rates for 2 Targeted Healthcare-Associated Infections. (24th April 2015)

• Record Type: Journal Article
• Authors: Kawai, Alison Tse; Calderwood, Michael S.; Jin, Robert; Soumerai, Stephen B.; Vaz, Louise E.; Goldmann, Donald; Lee, Grace M.
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 8(2015)
• Page Start: 871
• Page End: 877
• Publication Date: 2015-04-24
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.86
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>BACKGROUND</title> <p>The 2008 Centers for Medicare & Medicaid Services hospital-acquired conditions policy limited additional payment for conditions deemed reasonably preventable.</p> </sec> <sec id="abs2" sec-type="general"> <title>OBJECTIVE</title> <p>To examine whether this policy was associated with decreases in billing rates for 2 targeted conditions, vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infections (CAUTI).</p> </sec> <sec id="abs3" sec-type="general"> <title>STUDY POPULATION</title> <p>Adult Medicare patients admitted to 569 acute care hospitals in California, Massachusetts, or New York and subject to the policy.</p> </sec> <sec id="abs4" sec-type="general"> <title>DESIGN</title> <p>We used an interrupted times series design to assess whether the hospital-acquired conditions policy was associated with changes in billing rates for VCAI and CAUTI.</p> </sec> <sec id="abs5" sec-type="results"> <title>RESULTS</title> <p>Before the policy, billing rates for VCAI and CAUTI were increasing (prepolicy odds ratio per quarter for VCAI, 1.17 [95% CI, 1.11–1.23]; for CAUTI, 1.19 [1.16–1.23]). The policy was associated with an immediate drop in billing rates for VCAI and CAUTI (odds ratio for change at policy implementation for VCAI, 0.75 [95% CI, 0.69–0.81]; for CAUTI, 0.87 [0.79–0.96]). In the postpolicy period, we observed a decreasing trend in the billing rate for VCAI and a leveling-off in the billing rate for CAUTI (postpolicy odds ratio per quarter for VCAI, 0.98 [95% CI, 0.97–0.99]; for CAUTI, 0.99 [0.97–1.00]).</p> </sec> <sec id="abs6" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>The Centers for Medicare & Medicaid Services hospital-acquired conditions policy appears to have been associated with immediate reductions in billing rates for VCAI and CAUTI, followed by a slight decreasing trend or leveling-off in rates. These billing rates, however, may not correlate with changes in clinically meaningful patient outcomes and may reflect changes in coding practices.</p> <p> <italic>Infect. Control Hosp. Epidemiol</italic>. 2015;36(8):871–877</p> </sec> </abstract>