KU and Truman hospitals are hit with controversial Medicare penalty again

The University of Kansas Hospital and Truman Medical Center are among 751 hospitals nationwide that will have their Medicare payments docked 1 percent as a penalty for preventable complications.

It’s the fourth straight year that the two hospitals will be subject to the penalty, which was enacted as part of the Affordable Care Act, or Obamacare. The federal Centers for Medicare and Medicaid Services assess hospitals based on their rates of several complications, including infections and injuries like bed sores and hip fractures. The agency penalizes the hospitals that score among the worst 25 percent in the country.

Health care analysts have criticized the program since it started for disproportionately affecting teaching hospitals and those that serve low-income populations, like KU and Truman. This year’s penalty list included nationally well-regarded medical centers like the Mount Sinai Hospital in New York City, Northwestern Memorial Hospital in Chicago and Stanford Health Care hospitals in California.

Truman is a teaching hospital affiliated with the University of Missouri-Kansas City School of Medicine and also serves as the safety net hospital for Jackson County.

Charlie Shields, Truman Medical Center’s CEO, said that means the facility serves patients with complex conditions who already have socioeconomic strikes against them that make them more susceptible to the types of conditions the federal government is penalizing hospitals for.

“Essential hospitals like Truman, serving society’s most vulnerable, struggle to raise above the ‘safety net ceiling’ being imposed by the federal government’s hospital rating system,” Shields said in an emailed statement. “We urge the federal government to develop a rating system that consumers can have confidence in.”

Tim Williamson, the vice president of quality and safety at the University of Kansas Health System said in an emailed statement that KU is “continuously working to reduce rates of hospitalized conditions.” Williamson said that he agreed with the spirit of the federal plan to use financial incentives to reduce complications, but “the program remains deeply flawed.”

“As many have pointed out, it disproportionately penalizes academic medical centers that take care of the sickest of the sick,” Williamson said.

More importantly, Williamson said, the federal program relies on data that is often two years old, so it doesn’t account for recent improvements.

“It’s like trying to drive a semi-truck by only looking in the rearview mirror,” Williamson said.

Williamson pointed to other evaluators who gave KU high marks, including the Leapfrog hospital rating service, an academic medical center data collaborative called Vizient and the U.S. News and World Report magazine.

Truman and KU are among seven hospitals in Kansas and nine in Missouri subject to the penalty this year. The only other facility in the Kansas City metro area is Blue Valley Hospital, an outpatient surgical center in Overland Park.

A spokeswoman for Blue Valley Hospital declined to comment.

The Medicare penalty is also being applied to St. Francis Hospital in Topeka, which KU purchased this year in partnership with a private health care company.

The penalty is retroactive to the beginning of the federal fiscal year, which started in October, and will be assessed on all patient stays and medical resident payments between then and the end of September 2018. The amounts will vary depending on how many Medicare patients the hospitals see and what services they perform for them. Medicare serves mostly Americans 65 or older.

This story was originally published December 26, 2017 at 2:34 PM with the headline "KU and Truman hospitals are hit with controversial Medicare penalty again."