Are teaching hospitals treated fairly in the hospital-acquired condition reduction program?

Purpose (CMI); (4) number of staffed beds; (5) showed that teaching hospitals, larger To identify the factors associated with length of stay (LOS); (6) gross patient hospitals (> 400 beds), hospitals with total Hospital-Acquired Condition revenue; and (7) region, using data high CMI or long LOS, and hospitals Reduction Program (HACRP) score and from CMS and the American Hospital in the Northeast and Western United with receiving a Centers for Medicare Directory. They conducted multivariate States were more likely to receive a and Medicaid Services (CMS) penalty linear and logistic regressions. penalty. Teaching hospitals and larger (1% reduction in payment to those hospitals did not improve their scores hospitals in the lowest-performing Results over time compared with nonteaching quartile of HACRP scores) for fiscal years A total of 2,249 hospitals were and small hospitals. (FYs) 2015–2017 with a particular focus included. The mean total HACRP on trends over this period. scores across hospitals for FY15, FY16, Conclusions and FY17 were 5.38, 5.35, and 5.18, A reevaluation of the scoring Method respectively. In FY15, 21.2% (476/2,249) methodology for the HACRP is needed. The authors evaluated the following of hospitals received a penalty CMS could stratify hospitals into variables: (1) type of hospital (teaching compared with 22.6% (508/2,249) in homogeneous categories and apply vs. nonteaching); (2) disproportionate FY16 and 31.3% (704/2,249) in FY17 penalties to those that have the worst patient percentage; (3) case mix index (P < .001). The logistic regression model scores in each category.