Local hospital receives penalty after Affordable Care Act review

Posted: 7:00 am, December 26, 2014 by Reporter Heather Young

Twin Cities Hospital hit with 1-percent reduction of Medicare dollars

Twin Cities Community Hospital will receive 99 percent of Medicare dollars for the patients it treated due to its score when it was evaluated on central blood stream infections, urinary tract infections and patient safety measures from July 1, 2011 to June 30, 2013, through the Hospital-Acquired Condition Reduction Program. The program is the newest effort under the Affordable Care Act that works to reduce hospital-acquired conditions, says Centers for Medicare & Medicaid Services Public Affairs Specialist Alper Ozinal.

Twin Cities received a score of 8.6750, with scores ranging from one to 10 and any facility getting a score higher than 7 being assessed a one percent fine for the 2015 fiscal year — Oct. 1 through Sept. 30, 2015.

Twin Cities Community Hospital Chief Nursing Officer Carol Howland said that the hospital had zero cases of central line-associated bloodstream infections in 2012 and 2013.

“Our hospital is engaged in an ongoing effort to reduce hospital-acquired infections,” Howland said. “For example, Twin Cities Community Hospital was nationally recognized by the Department of Health and Human Services as part of Critical Care Collaborative 2012 for elimination of central line associated bloodstream infection. In addition Twin Cities has received the Silver Beacon award from the American Association of Critical Care Nurses for excellence in care. We continue to work toward a goal of zero hospital-acquired infections.”

Of the 3,400 hospitals evaluated during those two years, 724 hospitals will have their Medicare payments reduced by one percent for the 2015 fiscal year, Ozinal said. Medicare will have an approximate $373 million savings due to the one percent penalty to the hospitals. According to the Centers for Medicare & Medicaid Services, the savings are due to not providing additional Medicare payment for treatment of reasonably preventable conditions that have been acquired after the Medicare beneficiary was admitted to the hospital.

“Those are dollars that end up coming back to the Medicare program,” Ozinal said.

Twin Cities is a for-profit hospital under the umbrella of Tenet, which also owns Sierra Vista Regional Hospital in San Luis Obispo. Sierra Vista had an overall score of 3.3250 and will not be fined. The scores were available to the evaluated hospitals in September, giving those with scores above 7 the opportunity to be re-evaluated. Ozinal said four hospitals were re-evaluated. The one percent penalty went into effect on Oct. 1.

“Twin Cities Community Hospital is committed to delivering safe, high-quality care to every patient,” Howland said in response to the hospital’s score and penalty.

The hospitals were judged on the following:

Clinical Process of Care: 20 percent
Patient Experience of Care — HCAHPS survey: 30 percent
Outcome — hospital mortality measures for acute myocardial infarction, heart failure, and pneumonia and the central line-associated bloodstream infection measure: 30 percent
Efficiency — Medicare Spending per Beneficiary measure gauges efficiency by calculating total cost to Medicare for hospital’s episodes: 20 percent