Ten Houston-area hospitals have been penalized by the feds for having high rates of infections or injuries that patients acquire during their stays, according to the federal Centers for Medicare and Medicaid.
The financial penalties, which slash 1 percent of the hospital's federal Medicare funds, are part of a three-year-old Affordable Care Act program intended give hospitals an incentive to reduce their rates of preventable patient infections and injuries — or face consequences. Those infections or injuries include MRSA, blood clots, bed sores, hip fractures from bad falls, and line infections that get into the bloodstream, among others.
Nationwide, 769 hospitals, including 61 in Texas, were penalized for the fiscal 2017 year. (Penalized hospitals include the bottom 25 percent of more than 3,300 hospitals with highest rates of infection or injury; see a list of the Houston-area hospitals at the bottom of this article.) According to the Association of American Medical Colleges, this translates to hospitals' losing an estimated $430 million — which is 18 percent more than hospitals lost because of penalties last year — and most large hospitals will lose more than $1 million.
Texas Hospital Association spokesman Lance Lunsford said that numbers show the incentive program appears to have compelled hospitals to work harder at preventing infections; what the feds call "hospital-acquired conditions" have declined 21 percent nationally from 2010 to 2015, according to the federal Agency for Healthcare Research and Quality. But the program is not without its flaws, Lunsford said — particularly in Texas.
In Texas, he said, the hospital industry has been accustomed to various Medicaid and Medicare cuts in different areas of health care over the past several years. Plus, state government has also refused to expand Medicaid, which would award Texas health care providers an additional $6 billion in funding per year to take care of low-income patients. As a result, Lunsford said, although the financial penalties are ultimately supposed to incentivize hospitals to provide better care for patients, they're also an ironic obstacle impeding hospitals from doing better with less money.
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"It's absolutely justified as a major concern, especially in Texas," Lunsford said. "Those hospitals who are already financially at risk are even more troubled in trying to achieve a bottom line."
It's unclear what each hospital's rate of infection or injury was, but as Kaiser Health reported, the Agency for Healthcare Research and Quality estimates there were 3.8 million hospital injuries last year, or 115 injuries during every 1,000 patient hospital stays.
Here are the Houston and greater Houston-area hospitals penalized by the feds; asterisks indicate the hospital is a repeat offender:
Aspire Behavioral Health of Conroe (Conroe)
Bayshore Medical Center (Pasadena)
*CHI St. Luke's Health - Baylor College of Medicine -Texas Medical Center (Houston)
*United Memorial Medical Center (formerly Doctors Hospital Tidwell) (Houston)
**HopeBridge Hospital (Houston)
Memorial Hermann - Texas Medical Center (Houston)
Houston Methodist Hospital (Houston)
*CHI St. Luke's Health - The Vintage Hospital (Houston)
CHI St. Luke's Health - The Woodlands Hospital (The Woodlands)
*Memorial Hermann Surgical Hospital - First Colony (formerly Sugar Land Surgical Hospital) (Sugar Land)