Infection Management & Cost
CRMD infections are difficult to manage.
- CRMD infection costs exceed reimbursement…
 …And reimbursement for hospital-acquired infections is at risk.
- Medicare has begun to stop compensating hospitals for treating certain “reasonably preventable” Hospital Acquired Conditions”
- Hospital Acquired Conditions (HACs) - high volume and high cost
- As of October 2008, eight preventable events including urinary-tract infections, vascular-catheter-associated infections and mediastinitis were categorized as “never pay” events
- CMS continues to require that hospitals report, and make publically available, 30 quality (outcome) measures
- CMS continues to require that hospitals report all diagnoses (e.g., infection) that were acquired during a hospital stay or Present on Admission (POA)
- CMS will perform a “robust program evaluation,” including POA analysis, to determine future changes to the HAC list
- 2009 national average reimbursement rates for DRG 243 and 227 derived from 2009 IPPS final rule: Wise, R. et al. Medical Supplies and Devices. Leerink Swan Healthcare Equity Research. May 4, 2009.
Darouiche, N Engl J Med 2004 350, 1422.
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