Hilton Head Hospital penalized by Medicare program
Hilton Head Hospital will lose some federal funding this year for failing to keep patients safe from preventable conditions that develop while in the hospital's care.
The medical center was among 16 South Carolina hospitals that will lose 1 percent of Medicare payments through the fiscal year that began in October through the Medicare Hospital-Acquired Condition Reduction Program
The program, started by the Affordable Care Act, commonly known as Obamacare, was created to penalize hospitals that rank among the worst quartile in the nation in avoiding a group of preventable medical complications that can develop during a patient's stay.
Officials at the Hilton Head Hospital could not predict how much the penalty would cost the hospital Tuesday, but The S.C. Hospital Association estimates the 16 penalized hospitals in this state will lose a total of about $7.5 million.
Conditions measured to calculate a hospital's score include urinary tract infections from catheters, surgical site infections and postoperative hip fractures, among others.
Hospitals are ranked with a score from one to 10, with ten as the worst. This fiscal year, hospitals that fell above 6.75 will lose the funding.
With a score of 8.25, Hilton Head Hospital was tied for the fourth worst score in South Carolina.
The hospital responded to the designation with a statement detailing improvements it has made to reduce the conditions including forming teams focused on the prevention of central-line associated bloodstream infections and surgical site infection prevention and an Antimicrobial Stewardship program.
Beaufort Memorial hospital,in contrast, showed great improvement in its score this year after it ranked among the bottom quartile and lost funding last year.
The hospital is now in the best twentieth percentile of hospitals in the country in preventing conditions the Medicare program tracks, improving its score from 7.25 in fiscal year 2015 to 2.75 this year.
An aggressive effort focusing on prevention and tracking risks made a significant difference in the hospital's numbers, said Shawna Doran, Director of Quality and Regulatory Affairs at Beaufort Memorial.
"We had already been putting into place quality control teams before we were notified of our score last year and I think this is the fruits of that labor," Doran said. "We now have a daily safety huddle with leaders throughout the entire organization that go over safety issues every single day."
A change in philosophy about the standards for preventing harm to patients has also driven the initiative in Beaufort Memorial and hospitals nationally, said Dr. Kurt Gambla, Chief Medical Officer at the hospital.
"In this industry we're no longer OK with close enough to perfect," Gambla said. "Now there has been a real change in philosophy agreeing we need to get to raise the bar to getting to zero harm."
A third local hospital, Coastal Carolina Hospital in Hardeeville was also ranked this year in the top 30th percentile for scores in the program.
Hospital professionals say the penalties and public rankings though the Medicare program has been able to drive improvements and save medicare costs for the preventable conditions it tracks.
"Hospitals need to be accountable and the federal government was aware of how much was being paid out for these conditions they considered unnecessary costs to the system," said Lorri Gibbons, Vice President of Quality Improvement and Patient Safety with the South Carolina Hospital Association.
Gibbons said, however, that in many cases recent improvements are not measured in hospitals' scores as the program measures data from 2013 and 2014.
"I think that you will see widespread improvements in South Carolina hospitals when 2015 numbers are taken into account," Gibbons said. "It takes some time for change to trickle, but there has been a real commitment to improvement."
Contact reporter Erin Heffernan on Twitter at twitter.com/IPBG_erinh.
Related content:
- Beaufort Memorial penalized by federal Medicare program, January 3, 2015
- AP: Medicare penalizing hospitals over infections, injuries, December 14, 2015
This story was originally published December 15, 2015 at 4:43 PM with the headline "Hilton Head Hospital penalized by Medicare program ."