The federal government’s tougher enforcement against hospitals with higher-than-average patient complication rates means 16 hospitals in South Carolina will be docked one percent of their Medicare payments next year.
Federal regulators with the Centers for Medicare and Medicaid Services said the hospital-acquired infection rates and surgical complications among patients at those hospitals were above national standards. This the second year that Medicare officials have dinged hospitals under the Affordable Care Act’s punishment-and-reward system. Officials hope the lost revenue spurs hospitals into finding better ways to prevent unnecessary medical spending.
In all, the federal penalties will affect 758 hospitals nationwide for an average of about $500,000 in lost reimbursement each through the rest of the fiscal year that ends in September. Some hospitals with a larger percentage of Medicare patients could more than $1 million in lost reimbursements, however. Affected hospitals scored in the bottom quartile of the rankings.
The South Carolina Hospitals Association said that would be a significant loss to affected hospitals, particularly the smaller ones. “Medicare is the biggest third-party payer for the hospitals,” the group’s Vice President for Quality and Safety Lorri Gibbons said. “So, when you take a hit of one percent, it could be significant to the hospital’s operating baseline. It doesn’t sound like much, but it can be a significant hit, depending on the hospital.”
Penalized hospitals in South Carolina include MUSC, Bon Secours, and Trident in Charleston, as well as Palmetto Health in Columbia and Spartanburg Regional. No hospitals in Greenville were affected. Another ten facilities from smaller cities and communities from across South Carolina were also listed. The list included Marlboro Park Hospital in Bennettsville, which closed its doors for good earlier this year.
The fines are based on the frequency of infections and other complications between July 2012 and June 2014, according to Kaiser Health News’ analysis of the penalties. Gibbons said the hospital association feels Medicare officials should change their criteria to use data within the past year.
“Change takes awhile before you see improvement and some of this data is really old,” she said. “It’s not real-time data.”
List of impacted hospitals in South Carolina. Also indicates whether Medicare also punished hospital in past fiscal year
Aiken Regional Medical Center — Aiken (also penalized in FY2015)
Marlboro Park Hospital — Bennettsville
Bon Secours-St. Francis Xavier — Charleston
MUSC Medical Center — Charleston (also penalized in FY2015)
Trident Medical Center — Charleston
Chester Regional Medical Center — Chester
Palmetto Health Baptist — Columbia (also penalized in FY2015)
Palmetto Health Richland — Columbia (also penalized in FY2015)
Conway Medical Center — Conway (also penalized in FY2015)
Mary Black Health System Gaffney — Gaffney (also penalized in FY2015)
Self Regional Healthcare — Greenwood
Hilton Head Regional Medical Center — Hilton Head Island
Springs Memorial Hospital — Lancaster
GHS Oconee Memorial Hosp. — Seneca (also penalized in FY2015)
Spartanburg Regional Medical Center — Spartanburg (also penalized in FY2015)
Tuomey Healthcare System – Sumter