The ACA’s Penalty Program for Patient Harm

Possible Contaminated Surfaces

Kaiser Health News published an article listing the 721 Hospitals penalized for patient safety. While this is interesting and probably good to know, it’s just a list. As a consumer of medical services, I would like to know which categories of Hospital Acquired Conditions these errors fell into. There’s a big difference between catching a cold in a hospital and getting bed sores. In addition, there’s no link in it to any information which might help with further data. The good news for us is that only one hospital in our county made it onto the list at all.

I went looking for more data on this subject, since it was all new to me. I found that the ACA (Affordable Care Act) has instituted three types of Medicare reimbursement penalty programs:

This is a lot of information to digest, but basically if a hospital does not score appropriately in these programs, it can be penalized a percentage of its CMS (Medicare/Medicaid) reimbursements. Since the programs are new, there isn’t enough data yet to tell whether the programs will be successful. When a retailer has an unsuccessful season or must raise its overhead, the losses end up getting passed to the consumer in the form of higher prices in order to keep the profit margins the same. Will hospitals do the same?


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