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Local hospital administrators say a change in Medicare reimbursement rates that goes into effect later this year will provide incentives to improve the quality of patient care. Both Geisinger and Wilkes-Barre General have invested in training and equipment to prepare for the move.
The Centers for Medicare and Medicaid Services, effective Oct. 1, will no longer reimburse hospitals for the costs of care for preventable conditions acquired by patients.
CMS will begin by eliminating payment for eight hospital-acquired conditions:
• Objects inadvertently left in a body after surgery
• Air embolism
• Blood incompatibility
• Catheter-associated urinary tract infections
• Pressure ulcers
• Vascular catheter-associated infection
• Surgical site infection
• Certain types of falls
Dr. Kenric Maynor, a hospitalist at Geisinger Wyoming Valley who is involved in patient safety initiatives, said the Medicare list did not come as a surprise, and quality of care measures should be applied regardless of funding.
Included in Medicare’s implementation of cutbacks on payments for additional costs of certain preventable hospital-acquired conditions are provisions to expand the list of publicly reported quality measures.
“This is a check on the quality of the institution and I think that the medical community can anticipate there will be more measures to come, and due surveillance and preventative measures will be reportable as transparent measures of quality,” Maynor said.
Maynor said Geisinger has worked to reduce and eliminate potentially preventable hospital-acquired conditions as much as possible. Upon admission, for example, patients who may be prone to falls are identified with different colored arm bands so staff can be constantly aware of which patients require extra help standing. Other measures include having standardized checks when blood is delivered to ensure blood compatibility, employing a wound-care team that does daily surveillance to check for bed sores and eliminating the unnecessary use of catheters.
Wilkes-Barre General Hospital also has taken steps to reduce preventable conditions, including making a significant investment in silver-coated catheters that inhibit the growth of bacterial organisms. The hospital also has changed a number of work procedures to improve quality, according to Bob Hoffman, vice president of patient care services.
“Fortunately, we’ve been preparing for these all along,” Hoffman said. “It’s the right thing to do. I think Medicare is trying to encourage hospitals to do quality care.”
Hoffman noted that the Medicare payment changes are related to the federal Deficit Reduction Act of 2005, which was touted by the current Bush administration as slowing the average annual growth rate of Medicare costs.
CMS said conditions are expected to be added to the list in future.

“It’s the right thing to do. I think Medicare is trying to encourage hospitals to do quality care.”

Bob Hoffman

Vice president of patient care services at Wilkes-Barre General Hospital