FAH Hospital Policy Blog

Perspectives on health policy affecting America's hospitals and the patients we serve.

Quality & Safety | FAH Policy Blog Team

Hospitals Improving Patient Safety, but Quality Program Needs Overhaul

Hospitals are dedicated to providing safe care to the communities they serve.  They have been working tirelessly to make patients safer by reducing hospital-acquired infections and it is paying off. But despite the success, some hospitals are still being penalized by a system that doesn’t recognize recent trends in improvement.

A recent report from the Agency for Healthcare Research and Quality (AHRQ) indicates that between 2014 and 2016, hospital acquired conditions were reduced nationwide by 8 percent.  AHRQ calculated that this reduction of 350,000 hospital-acquired conditions helped prevent an estimated 8,000 deaths and saved $2.9 billion over a period of two years.  This is a testament to the efforts of community hospitals in making care safer.

Much of the improvement can be attributed to the Partnership for Patients, which was launched in 2011 as a public-private partnership with a shared goal to help improve the quality, safety and affordability of health care of Americans.  The Federation of American Hospitals along with other hospital groups, and associations joined with CMS to form this alliance and one of the main goals is a 20% reduction in all-cause patient harm through the prevention of HACs. 

Our progress is evident, but in an odd twist, the Partnership’s success has highlighted the need for CMS to overhaul its HAC Reduction Program.

Currently, the HAC Reduction Program bases penalties on what is called a “tournament” model.  This “tournament” model, ranks hospitals relative to each other and penalizes those in the bottom ranks.  When it comes to HACs, facilities in the bottom 25th percentile receive a penalty of 1% of their IPPS payments.  Comparing hospitals to each other with no performance target means that even if a hospital is performing at a high level and has zero harm events, it could still be penalized.

This system simply isn’t fair. By not rewarding or fostering collaboration among hospitals, it goes against everything the Partnership stands for.

Hospitals are holding up their end of the deal. Our cooperation is leading to sustained improvement nation-wide. That is why it is time for policymakers to seriously consider shifting away from the competitive approach of tournament models and instead transition into a program that prospectively sets performance targets.  Let’s not risk penalizing high performers whose dedication to patient safety and commitment to the Partnership continues to help save lives.