Issue link: https://beckershealthcare.uberflip.com/i/683043
34 Executive Briefing Reducing Healthcare-Associated Infections: Medically and Financially By Rosie D. Lyles, M.D., M.H.A., M.S.c., Head of Clinical Affairs, Clorox Healthcare H ealthcare-associated infections often result in tremen- dous emotional and financial costs for patients and their families. For many HAIs, it is the hospital or payer — sometimes both — that bears much of the financial cost. Surgical site infections are one of the most common HAIs, with an average per-patient cost of $21,000 per infection. For antimicrobial-resistant SSIs, the cost can be as high as $60,000. 1 For central line-associated bloodstream infections, the cost averages $45,000. 2 Two key programs established by the Affordable Care Act are designed to incentivize hospitals to reduce their HAI rates. ACA Programs to Reduce HAIs The Value-Based Purchasing program is an incentive program based on quality of care, rather than quantity of care. To fund the program, a specified percentage of Medicare payments to hospitals are reduced and held each year. These funds are then redistributed to hospitals based on their total perfor- mance scores, which include measures for HAIs. Hospitals can Sponsored by: Table 1. Key Affordable Care Act (ACA) programs with incentives to reduce HAIs Value-Based Purchasing (VBP) Program – Key Features for Fiscal Years 2017-2020 CMS Fiscal Year (FY) Outcome Measures Performance Period Reduction/ Incentive 2017 CLABSI, CAUTI, SSI* (existing), C. difficile, MRSA bacteremia (new) (Safety domain) 1 January 2015 – December 2015 2.0% 2018 As for 2017 (Safety domain) 1 January 2016 – December 2016 2.0% 2019 As for 2018 (Safety domain) 2 THA/TKA 3 (Clinical care domain) July 2015-June 2017 January 2015-June 2017 2.0% 2020 As for 2019 (Safety domain) As for 2019 (Clinical care domain) July 2016-June 2018 July 2015-June 2018 2.0% 1 CLABSI and CAUTI in adult, pediatric and neonatal ICU; 2 CLABSI and CAUTI extended to include pediatric and adult medical, surgical, and medical/surgical wards 3 Hospital-Level Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty/Total Knee Arthroplasty. Includes complications from periprosthetic joint infection/wound infection. 6 Hospital-Acquired Condition (HAC) Reduction Program - Key Features for Fiscal Years 2017-2018 CMS Fiscal Year (FY) Domain 2 (NHSN) 1 Weight Performance Period Penalty 2017 CLABSI, CAUTI ,SSI*, C.difficile, MRSA bacteremia (new) 1 85% 2014-2015 1.0% 2018 As for 2017 2 85% 2016 1.0% 1 e program includes Domain 1 which is the AHRQ PSI-90 score and carries a weight of 15% 2 CLABSI and CAUTI in adult, and pediatric ICU; 3 CLABSI and CAUTI extended to include pediatric and adult medical, surgical, and medical/surgical wards * Colon surgeries including incision, resection, or anastomosis of the large intestine, and large-to-small and small-to-large bowel anastomosis; abdominal hysterectomy including laparo- scopic procedures