Health Care

After 4 years, KU Hospital freed from Medicare penalty that was costing it millions

The University of Kansas Hospital won’t be subject to a controversial Medicare penalty for the first time since the punishment for patient safety problems was introduced in 2015.

But Truman Medical Center remains on the penalty list for the fifth straight year, Research Medical Center rejoins the list for the first time since 2015 and Belton Regional Medical Center makes the list for the first time.

Officials at KU — and other hospitals locally and nationwide — have said the penalty doesn’t accurately reflect quality of care because it’s based on stale data and falls disproportionately on facilities that treat more fragile people.

Liz Carlton, KU Hospital’s vice president of quality and safety, said it was still gratifying that KU is no longer on the list of penalized hospitals, which Kaiser Health News published earlier this month.

“What you’ve been told before is exactly right: This data doesn’t take into account acuity of patients and it’s dated — it’s a few years old,” Carlton said. “But it’s another tool to measure your performance.”

The Medicare penalty is a feature of the Affordable Care Act, commonly called Obamacare. Hospitals across the country are graded on patients’ rates of conditions that develop in hospitals, like bloodstream infections, hip fractures due to falls, or injuries from surgery.

The worst 25 percent are subject to the penalty, which reduces their Medicare payments by 1 percent for the year. At KU, because of the high number of patients the hospital sees, that means several million dollars lost out of about $2 billion in total operating revenue.

Carlton said the hospital has been working on reducing hospital-acquired conditions, not because of the penalty, but to serve patients better. The key, she said, is training all hospital workers, from doctors and nurses to custodians and those who transport patients in wheelchairs and rolling beds.

“Everyone has to own it in order to make the difference,” Carlton said. “That’s really what has made the difference, and I’m glad the ratings are showing that.”

Truman officials, in a statement released by their media relations department, said the system used by the federal Centers for Medicare and Medicaid Services, or CMS, to decide who should be penalized is flawed.

“We agree with groups like America’s Essential Hospitals and the American Hospital Association when they point out CMS does not fully take into account factors like concurring chronic disease, health literacy, access to transportation, difficulty obtaining medicine and other socioeconomic factors — which can send a misleading message to consumers,” the statement said.

The penalties have been widely criticized, but federal officials say they continue to fine-tune the criteria. They released data in January that shows hospital-acquired conditions have been reduced by 13 percent since the program began, saving an estimated 20,500 lives and $7.7 billion.

Truman officials said they “have very robust programs” to prevent hospital-acquired conditions, including multidisciplinary teams combing through research for best practices, a 40-person group of unit leaders who meet daily to discuss patient safety and a policy of reviewing every hospital-acquired condition to find out why it occurred.

A spokeswoman for HCA Midwest, which owns Research Medical Center, said Research is also taking steps to reduce hospital-acquired conditions. That includes participating in a major study recently published in the British medical journal The Lancet that showed promise in preventing some of the most common hospital infections by bathing patients daily with a special antiseptic soap and using a nasal antibiotic.

Kansas City Star health reporter Andy Marso was part of a Pulitzer Prize-finalist team at The Star and previously won state and regional awards at the Topeka Capital-Journal and Kansas Health Institute News Service. He has written two books, including one about his near-fatal bout with meningitis.