Health Information Management

News: Contradictory data may point to questionable HAC reporting

CDI Strategies, August 20, 2015

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One might think that accredited, major academic medical centers wouldn’t need to worry about payment reductions associated with CMS’ hospital acquired condition (HAC) program. Think again, says a July 28 study from the Journal of the American Medical Association (JAMA).

The study found that “hospitals with the highest quality summary score[s] were penalized significantly more frequently than hospitals with the lowest quality score,” and that facilities which were accredited by the Joint Commission or major teaching hospitals “were more likely to be penalized” for HAC concerns.

Conditions count as HACs is they’re high cost or high volume or both, result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and could reasonably have been prevented through the application of evidence?based guidelines, according to CMS.

According to JAMA, “these paradoxical findings suggest that the approach for assessing hospital penalties in the HAC Reduction Program merits reconsideration to ensure it is achieving the intended goals.”

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