4 Ways to Reduce Penalties Under the Hospital-Acquired Condition Reduction Program

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486834549In our previous blog, we discussed Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition (HAC) Reduction Program as well as changes to the reporting measures you need to know about 2014. For this blog, however, we’ll focus on four tips you can use to decrease your risk of receiving penalties for high HAC rates. While this new HAC Reducation Program may seem overwhelming, you can improve your HAC scores by using the right analytics tools and following these four tips.

Four Tips to Decrease Penalties Under the HAC Reduction Program

  1. Proactively evaluate, measure, and optimize critical care processes and outcomes. As Don Berwick, MD, past president and CEO of the Institute for Healthcare Improvement says: “Every system is perfectly designed to achieve exactly the results it gets.” For example, due to high morbidity, mortality, and cost, a hospital may choose to initially focus on CLABSI by measuring the rate of CLABSI and then evaluating the process for central line insertion. Ensure the process is optimized to deliver CLIP (central line insertion practices) compliant line insertions each and every time by measuring process and outcome metrics. Once the process is optimized, monitor and maintain it while you tackle the next HAC prevention critical care process.
  2. Put the right coding processes in place to accurately capture your patients’ POA (present on admission) data. These processes will help hospitals avoid financial penalties that would otherwise occur if a pre-existing condition was not coded as POA and counted in the HAC Reduction Program.
  3. Apply what you’ve learned to create a culture of safety. Review cases of HAC to discover the source of the problem. Then apply what you’ve learned to improve your systems of care delivery. Yes, this is easier to say rather than to do because it will take organizational focus and commitment to create a culture of safety. Once the culture is in place, everyone on the team will be committed to improving care delivery and keeping patients safe.
  4. Consider active surveillance systems to identify HACs and potential patient harm. Most hospital and health systems still use passive reporting systems for HACs.  But for over 20 years, the literature has demonstrated that active surveillance systems detect more HACs  (7-10 x’s more) and detect them earlier, allowing potential for prevention or harm mitigation. Active surveillance systems increase an organization’s ability to learn from mistakes and intervene to deliver safer care and more rapid improvements compared to passive reporting systems.

Do you have high rates of HACs at your hospital? What have you done to prevent them?

Have you tried any of these solutions to reduce your HACs? If so, what were your results?


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