12 Minnesota hospitals face penalties for infection rates, bedsores

A dozen Minnesota hospitals face penalties from the federal Medicare program this year for high rates of patients with infections, bed sores or other preventable complications, according to federal data released this week.

Combining the new measure with existing financial penalties for high patient readmission rates, the data show the toll paid by hospitals that fall short of quality goals imposed under the Affordable Care Act.

Seven Minnesota hospitals made both penalty lists for the year that ended Oct. 1, including Hennepin County Medical Center, Maple Grove Hospital and the University of Minnesota Medical Center.

State health officials said they're disappointed that so many Minnesota hospitals are being penalized, even though the revenue loss is modest — 1 percent of Medicare inpatient payments — for their performance on hospital-acquired complications.

"We had hoped for a little bit better performance," said Mark Sonne­born, a vice president at the Minnesota Hospital Association.

Among the participating facilities nationally — mostly large general hospitals — Medicare penalized the 25 percent that had the worst scores on hospital-acquired conditions. The measure is based on widely accepted quality benchmarks — the share of patients in intensive care who develop catheter-related urinary tract or bloodstream infections, and patients who develop avoidable complications such as bed sores.

After years of effort to reduce infection and complication rates, Minnesota hospital leaders hoped that a smaller share of hospitals would make the Medicare penalty list. But 12 out of 50 hospitals total meant a penalty rate of 24 percent for the state — only slightly better than the national average.

The penalties come amid signs of progress in quality of hospital care. Collaboration among a group of Minnesota hospitals over the past three years on ways to reduce bloodstream infections resulted in a 69 percent reduction in these complications and a savings of $5 million in unnecessary health care costs, the hospital association reported. Despite being penalized, HCMC has been a leader in the effort, and one of six demonstration hospitals to reduce infections associated with catheter placements for patients outside intensive care units.

Medicare's penalties vary more for hospitals with higher-than-expected readmission rates — patients returning within 30 days of being discharged. Such hospital readmissions sometimes reflect poor discharge planning and sending patients home without the information and follow-up medical care to take care of themselves.

While the readmission penalties can reach 3 percent of Medicare payments, only Minnesota hospitals in Fairmont, Hastings, Owatonna and Red Wing had readmission penalties above 1 percent for 2015.

Also on Thursday, Medicare released total scores for its value-based hospital program — which issues rewards for hospitals based on, among other things, patient feedback on features such as cleanliness of rooms and the attentiveness of nurses.

Fairview Northland Medical Center in Princeton had one of the highest scores on the quality measure, meaning it is in line for a more substantial reward from Medicare. And while Maple Grove Hospital and Cambridge Medical Center both face penalties for their readmission and hospital-acquired condition scores, their value-based scores were among the highest in Minnesota, meaning they will be penalized by Medicare on one hand, but rewarded on the other.