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Focus on infections to ensure CMS reimbursement

Quality Improvement Monitor, February 8, 2008

Hospitals that plan to screen every single patient for urinary catheter-associated infections to avoid paying for preventable conditions may want to keep this in mind: The government will be watching.

"Increased use of the present-on-admission [POA] variable is certainly going to occur as it is implemented in states across the country, but what we don't want to see happen is the unintended consequence that there's increase and potentially unnecessary use of diagnostic testing on admission," said Chesley Richards, MD, MPH, FACP, deputy director of the Division of Healthcare Quality Promotion National Center for Preparedness, Detection, and Control of Infectious Diseases for the Centers for Disease Control and Prevention (CDC).

"The example we've already been hearing about is people doing unnecessary testing for . . . patients who have catheters but who are not symptomatic with urinary tract infection [UTI] on admission," said Richards, who spoke during a December 2007 HCPro audioconference. "Before diagnosing a UTI, clinical symptoms should be present."

CMS will monitor these issues as well, according to Thomas Valuck, MD, MHSA, JD, medical officer and senior advisor to Herb Kuhn, acting deputy administrator of CMS.

Access the full story in the February issue of the Quality Improvement Report; access is free for subscribers, nonsubscribers can purchase a copy of the story for $10./p>

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