In 2019, Medicare penalized 800 U.S. hospitals for the high number of injuries and infections suffered by their patients. The penalties were enacted through a program in the Affordable Care Act where the federal government cuts Medicare reimbursements for hospitals with high rates of patient infections and injuries. The idea being that if hospitals suffer financially for poor outcomes, hospitals might improve the quality of care they provide.
Hospital patients suffered an avoidable injury in 9 out of every 100 hospital stays in 2016, or about 2.7 million times, according to a June report from the federal Agency for Healthcare Research and Quality.[1] Such injuries include adverse medication reaction, injury from a procedure, falls, or infections.
Sadly, our hospitals do not seem to be getting the message. Medicare has punished over 1,500 hospitals at least once.[2] In 2019, 110 hospitals were punished for a fifth straight time.[3] The 800 hospitals penalized in 2019 was the highest number since the since the program was created.[4]
Virginia hospitals fared especially poorly. Medicare punished 18 Virginia hospitals in 2019, listed below[5] with Southwest Virginia hospitals in bold:
- Sentara RMH Medical Center in Harrisonburg
- Sentara Norfolk General Hospital
- University of Virginia Medical Center in Charlottesville
- Carilion Roanoke Memorial Hospital in Roanoke
- VCU Health System in Richmond
- Novant Health UVA Prince William Medical Center in Manassas
- Southside Regional Medical Center in Petersburg
- Bedford Memorial Hospital in Bedford
- Carilion Franklin Memorial Hospital in Rocky Mount
- Inova Fair Oaks Hospital in Fairfax
- Hiram Davis Medical Center in Petersburg
- Reston Hospital Center
- Chippenham and Johnston-Willis hospitals in Richmond
- Lewisgale Hospital in Pulaski
- Carilion Tazewell Community Hospital in Tazewell
Many of the Virginia hospitals punished in 2019 have been punished by Medicare in the past.[6] The best thing patients can do is to thoroughly research hospitals where they are considering receiving care. In times of an emergency, patients may not be able to choose their hospital. But for non-emergency situations, patients have more options.
Publicly available information is
becoming more and more accessible. A great starting point is this database maintained
by the Kaiser Family Foundation on which hospitals have been penalized by
Medicare for poor outcomes.
[1] Agency For Healthcare Research and Quality, U.S. Department of Health and Human Services, AHRQ National Scorecard on Hospital-Acquired Conditions Updated Baseline Rates and Preliminary Results, 2014-2016, (June 2018), available at https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/natlhacratereport-rebaselining2014-2016_0.pdf.
[2] Jordan Rau. Look Up Your Hospital: Is It Being Penalized By Medicare?. Kaiser Health News. (Mar. 1, 2019), available at https://khn.org/news/hospital-penalties/?penalty=hac.
[3] Jordan Rau. Medicare Trims Payments to 800 Hospitals, Citing Patient Safety Incidents. Kaiser Health News. (Mar. 1, 2019), available at https://khn.org/news/medicare-trims-payments-to-800-hospitals-citing-patient-safety-incidents/?utm_campaign=KHN%3A%20First%20Edition&utm_source=hs_email&utm_medium=email&utm_content=70379732&_hsenc=p2ANqtz–jVTYTEQbjLtSjZS24-NBlqf1PZSO0EtnHOyEJ0p0PaprvWjCjhmGnbwDk2SxUkdYdeqjeQgosIxO8BZQpuCie1_SGl9Vcwuz7ob2U_UhOiSuwy9Y&_hsmi=70379732.
[4] Id.
[5] Katie O’Connor, Virginia Hospitals Among Those Penalized By Medicare. Virginia Mercury. (Mar. 13, 2019), available at https://www.virginiamercury.com/blog-va/virginia-hospitals-among-those-penalized-by-medicare/.
[6] Id.