UMC penalized for taking care of “the sickest of the sick”
University Medical Center has once again made a national list of hospitals being penalized by The Centers for Medicare & Medicaid Services (CMS) for failing to curb “hospital-acquired conditions and infections.”
769 hospitals in the CMS report, including UMC in El Paso, will lose one percent of Medicare payments over the 2017 fiscal year. The Hospital-Acquired Condition Reduction Program was created under the Affordable Care Act with the goal of pushing hospitals to reduce infections acquired within their facilities.
UMC has been penalized every year since the program’s inception in 2014, according to a report published by Beckers Hospital Review.
UMC Spokesman Ryan Mielke told ABC-7 CMS has a “broken and misleading methodology” that “incorrectly compares hospitals with widely disparate missions and patient populations.” Sixty senators and 275 representatives have signed a letter protesting the CMS methodology, Mielke added.
CMS is a federal agency within the Department of Health and Human Services (HHS) that administers the Medicare program and works with state governments to administer Medicaid services.
“We take in the sickest of the sick. Some of the patients we take in are much more sicker than those in private hospitals,” Mielke said, adding it’s misleading for CMS to compare public hospitals like UMC with private hospitals that turn away patients who cannot afford to pay for medical services. “If compared with similar hospitals with similar patient populations, we are confident that we would certainly be rated more favorably,” Mielke said.
A report published by Kaiser Health News cites information from the Association of American Hospitals stating hospitals will lose about $430 million in Medicare payments, 18 percent more than they lost last year.
Mielke said he could not provide an estimate of how much UMC stands to lose in Medicare payments in 2017 without first speaking with the hospital’s chief financial officer. UMC adjusted its budget to account for the loss of a small percentage of its Medicare revenue, Mielke added.
“Our quality of service and care remains among the best in our region and industry,” Mielke said, “The point is simple: hospitals that treat a much higher quantity of the sickest of patients will experience a higher infection rate than hospitals with a select patient population.”
