Controversial Affordable Care Act Requirement Penalizes Pennsylvania Hospitals for High Number of Patient Injuries

Affordable Care ActDue to a stipulation that was included in the Affordable Care Act requiring a quarter of the worst performing hospitals in patient injuries to lose out on a certain percentage of Medicare funding from the Federal government, a total of 751 hospitals including some found in Pennsylvania, find themselves being penalized due to this recent measure. This provision that started four years ago states that all hospitals that fall into this bottom percentile automatically lose 1 percent of their Medicare payments from the government over the federal fiscal year (October through September).

Ideally, these penalties were included in the Affordable Care Act as a way to incentivize hospitals in a financial manner to try and avoid a large number of ailments that patients could end up suffering from. These include afflictions such as bedsores, hip fractures, blood clots as well as the hospital-acquired infections (HAIs) one could get from hysterectomies and colon surgeries. The clear hope was that by taking money away from the hospitals who found themselves in these situations, they would then work harder to treat their patients better and give them more attention in order to try and stop these negative symptoms to occur. By improving the caliber of the care they are giving their patients hospitals would hopefully reduce the number of patients who fell into these categories and therefore they would not fall victim to penalties of this kind.

It is not a surprise that close to a majority of the hospitals (one-third) found on this list were categorized as teaching hospitals, although there was at least some improvement over last year when nearly half of all hospitals on the lists were teaching schools. There are some that argue that this is a label they are unfairly given, as academic hospitals are known to be more prone to infections and conditions such as these. This is because they deal with an extensive number of patients who hold a bigger risk of getting infections as compared to other types of hospitals that do not take care of such a large number of higher risk patients.

In all, 23 percent of all hospitals that were evaluated by Medicare were penalized due to the rules of this program. Pennsylvania has 32 of the 751 hospitals on this list with more than half of them (17 total) being repeat offenders from the prior year. Pennsylvania is not alone on this list as every single other state besides Maryland also finds themselves on here, Maryland only being exempt because their state has other arranged plans with the federal government for their Medicare payments. On a positive note, 336 hospitals that lost money by being on the list last year improved enough to not find themselves on the list again this year including two in Pennsylvania, which were Geisinger Medical Center in Danville and the Hospital of the University of Pennsylvania in Philadelphia.

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