Medicare's Policy to Limit Payment for Hospital-Acquired Conditions: The Impact on Safety Net Providers
Medicare's Policy to Limit Payment for Hospital-Acquired Conditions: The Impact on Safety Net Providers
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DOI：
10.1353/hpu.2011.0058
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发表时间：
2011-05-01
影响因子：
1.4
通讯作者：
Van Dyke, Kevin
中科院分区：
文献类型：
--
作者：
McHugh, Megan;Martin, Timothy C.;Van Dyke, Kevin
2008年，医疗保险实施了一项政策，限制对医院治疗可避免的医院获得性疾病（HAC）的报销。虽然这项政策将在2011年在全国范围内扩大到医疗补助计划，但对安全网医院的影响知之甚少。使用2006年美国医院协会年度调查和MEDPAR的数据，我们比较了安全网和非安全网医院符合HAC标准的病例发生率。我们发现，安全网医院每1,000名医疗保险出院者平均有65.5名HAC，而非安全网医院为57.6名。财务利润最低的五分之一医院的平均HAC率高于其他医院。安全网医院和财务利润率最低的医院可能比其他医院更有可能受到减少人道主义援助付款的政策的影响。
In 2008, Medicare implemented a policy limiting reimbursement to hospitals for treating avoidable hospital-acquired conditions (HACs). Although the policy will expand nationally to Medicaid programs in 2011, little is known about the impact on safety-net hospitals. Using data from the 2006 American Hospital Association Annual Survey and MEDPAR, we compared the incidence of cases that met the HACs criteria at safety-net and non-safety-net hospitals. We found that safety-net hospitals had an average of 65.5 HACs per 1,000 Medicare discharges compared with 57.6 at non-safety-net hospitals. Hospitals in the lowest quintile for financial margins had higher rates of HACs on average than other hospitals. Safety-net hospitals and hospitals with the lowest financial margins may be more likely than others to be affected by policies that reduce payment for HACs.