Hospitals Making Progress Toward Meeting Infection Reporting Requirements, Survey Finds

Hospitals tasked with meeting the Centers for Medicare & Medicaid Services(CMS) healthcare-associated infection (HAI) reporting requirements are making progress, according to a Premier healthcare alliance survey.

By January 2011, as outlined in the FY 2011 final rule, Medicare will require all hospitals participating in the Inpatient Prospective Payment System (IPPS) to:

- Enroll in the Center for Disease Control and Preventions (CDC) National Healthcare Safety Network (NHSN)

- Collect and report data on specific central line-associated bloodstream infections (CLABSIs)

Those that do not meet these requirements by January 2011 and do not submit data to CDC/NHSN will be subject to a two percentage point reduction in their Medicare inpatient annual payment update for FY 2013.

According to a survey of participants on Premiers Aug. 25 Advisor Live teleconference, "Using NHSN for new CMS requirements,"

- Nearly 60 percent of respondents are already enrolled in the NHSN

- Forty-one percent of respondents are both enrolled in NHSN and currently submitting CLABSI data.

More than 2,300 healthcare representatives joined the teleconference, which featured Premiers Danielle Lloyd, senior director for Reimbursement Policy, and Daniel Pollock, MD, surveillance branch chief, Division of Healthcare Quality Promotion Centers for the CDC, discussing the use of NHSN to meet the new CMS reporting requirements for CLABSIs.

According to Lloyd, "the final Medicare policies incorporate numerous quality measures that hospitals should understand to avoid payment cuts. The ability to focus on evidence-based care, compare against others, work with physicians, make changes in performance and use appropriate coding will help hospitals steer clear of these cuts while advancing patient safety and the quality of care they provide."

The CDC says there are approximately 3,000 hospitals registered with NHSN, while CMS data shows nearly 3,500 hospitals are currently subject to the pay for reporting requirements.

Surgical site infections reporting begins in 2012 with associated payment impact effective in 2014. Additional measures will likely be introduced in the future.

When asked what poses the greatest challenge for CLABSI reporting, of the nearly 1,000 respondents:

- 44 percent said experience and proficiency in using NHSN;

- 41 percent said enrolling in NHSN by January 2011;

- 16 percent said collecting denominator data.

"While not included in this IPPS rule, healthcare reform legislation also imposes payment penalties for certain hospital-acquired infections as part of value-based purchasing (VBP), and a separate penalty for hospital-acquired conditions," said Salah S. Qutaishat, PhD, director of surveillance and epidemiology at Premier. "It is imperative that hospitals focus on these infections and get rates as close to zero as possible, as performance data collected through NHSN could be incorporated into the reform policies in the future, and NHSN data will be made public on CMS Hospital Compare Web site."

The CDC and Premier announced in May a joint research initiative to test new technologies for predicting incidents of CLASBIs, as well as to automate the reporting of these adverse events to the NHSN.

Premier is one of the automated surveillance system vendors capable of supporting uploading of electronic HAI data to the NHSN. Premier also assists with NHSN enrollment, set-up and education for providers that have not enrolled, as well as training programs on data submission for clinicians.

Premiers SafetySurveillor has helped providers reduce infection rates leading to decreases in mortality and length of stay for infection cases while reducing costs; reduction in urinary tract infections; quicker intervention with appropriate drug therapy for critical patients; and reduced costs through the elimination of unnecessary MRSA screening for ICU patients.

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