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Web Exclusives |21 February 2017

Annals for Hospitalists Inpatient Notes - Legislating Quality to Prevent Infection—A Primer for Hospitalists

Jennifer Meddings, MD, MSc; Laurence F. McMahon Jr., MD, MPH

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Author, Article, and Disclosure Information
  • From University of Michigan Medical School and University of Michigan School of Public Health, Ann Arbor, Michigan.

    Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent those of the sponsor, the Agency for Healthcare Research and Quality, or the Department of Veterans Affairs.

    Acknowledgment: The authors thank Laura Petersen, MHSA, for providing assistance with references and manuscript editing.

    Financial Support: This work was funded by Agency for Healthcare Research and Quality grants 2R01HS018334 and 1K08HS019767.

    Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2738.

    Requests for Single Reprints: Jennifer A. Meddings, MD, MSc, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI 48109-2800; e-mail, meddings@umich.edu.

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Three major Medicare policies now target rates of catheter-associated urinary tract infection (CAUTI) and central line–associated bloodstream infection (CLABSI) as performance measures in hospitals. These Medicare value-based purchasing programs are designed to levy financial penalties to hospitals, based on infection rates (Table). Mandated by federal law, the goal of these programs is to motivate hospitals to improve safety while guaranteeing Medicare savings. Like many federal laws, these programs are complex, quickly implemented without prior validation, and poorly understood by the people who are directly affected—patients and clinicians. Many clinicians know that CAUTI and CLABSI are targeted as performance measures but do not understand exactly how their actions affect hospital payment. These policies yield Medicare savings because that is what they are designed to do. However, it is not clear whether these policies have improved clinical care.
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Meddings J, McMahon LF. Annals for Hospitalists Inpatient Notes - Legislating Quality to Prevent Infection—A Primer for Hospitalists. Ann Intern Med. ;166:HO2–HO3. doi: 10.7326/M16-2738

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Published: Ann Intern Med. 2017;166(4):HO2-HO3.

DOI: 10.7326/M16-2738

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2017 American College of Physicians
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