Monday, January 5, 2015

KC hospital system defends record as Medicare cuts loom

By Andy Marso
KHI News Service

TOPEKA, KAN. — A spokeswoman for Kansas City's largest hospital system defended its record on patient safety following an announcement last month that more than half its facilities are among those to be penalized by the federal government for hospital acquired ailments.

A total of 721 hospitals nationwide will lose 1 percent of their Medicare reimbursements in fiscal year 2015 because they scored poorly in federal metrics that measure the prevalence of conditions like urinary tract infections, central line infections and other complications patients acquire while in the hospital.

The metrics, and the accompanying penalties, were created by the Affordable Care Act as an attempt to improve patient care.

Five of HCA Midwest Health's nine Kansas City area facilities are among those getting docked, but company spokeswoman Christine Hamele cautioned against using the new federal metrics "as the only mechanism to monitor quality."

The hospital acquired conditions program "does not fully recognize hospitals for quality improvement and actually penalizes hospitals who are often caring for the most critical and vulnerable patients," Hamele, the company's assistant vice president for public relations and community affairs, said via email.

Hamele said HCA Midwest has been recognized for quality of care by several private sector organizations, including the Joint Commission, the country's largest hospital accreditation service. Other groups to honor HCA Midwest include the American Heart Association, the National Accredited Chest Pain Centers, the March of Dimes and The Leapfrog Group, a nonprofit that scores hospitals on patient safety.

The new federal metrics score hospitals on a 10-point scale, with 10 indicating higher incidences of hospital acquired conditions.

Among HCA Midwest's hospitals, Overland Park Regional Medical Center scored a 9.025 — the highest of any hospital in Kansas. Centerpoint Medical Center in Independence had the third highest score among Missouri hospitals, at 8.65. Menorah Medical Center in Overland Park (8.375), Research Medical Center in Kansas City, Mo., (8.025), and Lee's Summit Medical Center (7.9) also face the Medicare penalty. Belton Regional Medical Center (3) will not and HCA Midwest's other three facilities — Research Medical Center Brookside, Research Psychiatric Center and Lafayette Regional Health Center — were not scored.

HCA Midwest officials declined to say how the Medicare penalties would affect the company financially.

Hamele's comments about the limitations of the federal metrics echoed those of officials from academic medical centers, which were hit particularly hard by the penalties. Some complained that the federal metrics penalized hospitals that treat the most fragile patients or are most diligent about reporting their hospital acquired conditions.

Shalan Stroud, a critical care clinical nurse specialist who leads Shawnee Mission Medical Center's initiative to reduce such conditions, said underreporting was not a factor in her facility acquiring a score of 2 — the lowest in the Kansas City metro area.

“We report everything," Stroud said. "We report more than even what we have to report because we want to know how we’re doing.”

Stroud said Shawnee Mission Medical Center has been working with the Kansas Health Care Collaborative, a nonprofit dedicated to improving patient care, as well as the federal Centers for Disease Control and Prevention's National Healthcare Safety Network on programs to help curb hospital acquired ailments.

Stroud said the hospital's parent company, Adventist Health System, has given financial backing to help make the programs a success. Of the 49 Adventist hospitals nationwide that were part of the federal HAC scoring, 10 were penalized.

“They are very focused on helping in any way they can and providing us the resources we need to be able to prevent (hospital acquired conditions),” Stroud said.