CMS Changes in Reimbursement for HAIs: Setting A Research Agenda

描述（由申请人提供）：本申请请求支持将于2009年4月24日在纽约市纽约科学院举行的研究发展会议。这次为期一天的会议的目的是制定一个研究议程，以评估医疗保险和医疗补助服务中心（CMS）最近对医院相关感染报销政策的变化的影响。虽然这次会议是专门针对感染的，但讨论的许多问题以及由此制定的研究议程很可能适用于其他医院获得性疾病。在结构、过程和结果概念的框架下，我们将召集大约30名在制定卫生政策、制定实践准则以及为患者安全和感染预防和控制提供指导方面具有影响力的国家专家和研究人员，讨论医院可能采取的应对措施以及如何最好地评估这一政策变化的影响。我们的主要演讲者包括：1)CMS代表，他将提供政策变化的概述，选择特定条件的理由和预期变化；2) CDC代表，在考虑需要做什么研究时，提供重要的过程和测量问题的概述；3)一名卫生经济学家，他将讨论医院的激励措施和流程中的潜在变化，包括与最佳做法不相容的意外结果；4)组织行为学专家，他将讨论与结构和过程相关的问题，这些问题会导致积极的系统变化，从而促进期望的质量结果。

DESCRIPTION (provided by applicant): This application is requesting support for a research development conference to be held in New York City at the New York Academy of Sciences on April 24th, 2009. The aim of this one day conference is to develop a research agenda to assess the impact of the recent changes in the Centers for Medicare & Medicaid Services (CMS) reimbursement policies for hospital associated infections. While this conference is specific to infections, many of the issues and questions that are discussed as well as the resulting research agenda that is developed are likely to be transferable to other hospital-acquired conditions. Framed using the concepts of structure, process and outcomes we will bring together about 30 national experts and researchers who are influential in setting health policy, developing practice guidelines and providing direction for patient safety and infection prevention and control to discuss the potential responses by hospitals and how best to assess the impact of this policy change. Our key speakers include 1) a CMS representative who will provide an overview of the policy changes, the rationale for picking the specific conditions and the expected changes; 2) a CDC representative who will provide an overview of process and measurement issues that are important when considering what research needs to be done; 3) a health economist who will discuss the hospital incentives and potential changes in processes including unanticipated outcomes not compatible with best practices; and 4) an organizational behavior expert who will discuss issues related to structures and processes that lead to positive systematic changes that promote the desired quality outcomes. PUBLIC HEALTH RELEVANCE: Project Narrative The purpose of this conference is to develop a research agenda to assess the impact of the recent changes in Centers for Medicare & Medicaid Services (CMS) reimbursement policies for hospital associated infections (HAI), which are a large portion of hospital acquired conditions (HAC), and have significant impact on the health of the public. Convening a group of national experts to discuss the issues and articulate a research agenda to evaluate the policy change is a first step in gaining knowledge regarding its impact.