Alaska's four largest hospitals may face Medicare payment penalties because of high rates of infection and complications during inpatient stays, according to preliminary data analyzed by Kaiser Health News.
The federal government's crackdown is part of the Hospital-Acquired Condition Reduction Program created by the Affordable Care Act, which penalized a quarter of the nation's hospitals because of poor rankings involving a series of quality measures. The quality measurements look at the frequency of problems such as bloodstream infections in patients with catheters and other avoidable safety issues.
The Centers for Medicare and Medicaid Services recently identified Fairbanks Memorial Hospital and three Anchorage facilities -- Alaska Native Medical Center, Alaska Regional Hospital and Providence Alaska Medical Center -- as the hospitals in Alaska that fell into the lowest-performing 25 percent based on data from July 2012 to June 2013. The findings are preliminary and hospital officials say they expect the final numbers, which will analyze all 2013 infections, by fall.
If the Alaska hospitals retain their low rankings, Medicare will withhold 1 percent of every payment for a year beginning on Oct. 1. That translates to hundreds of thousands of dollars lost.
Providence Alaska Medical Center stands to lose between $500,000 and $700,000, said Dr. Richard Mandsager, the hospital's chief executive.
"Our budget is bigger than any other hospital in the state. So do I think we can handle it? Yes," Mandsager said about the federal penalty. "Is it big enough to get everyone's attention financially? Absolutely."
In 2012, the hospital reported 17 central line-associated bloodstream infections in intensive care units. Mandsager said the hospital took immediate action to remedy the infections, reviewing the fundamentals of inserting the tube and ensuring cleanliness. In 2013, that number shrank to six.
"It wasn't serendipitous that we had a high number one year and a lower number the next year," he said.
Julie Taylor, chief executive officer of Alaska Regional Hospital, said that between 2012 and 2013 the hospital had seven patients with blood clots, three patients with catheter-associated urinary tract infections, one fall and six patients with bacteria that can cause diarrhea and intestinal infections.
"Anything over one is a problem," Taylor said. "The message is that improvements are being made."
Taylor expects the hospital to lose about $300,000 in Medicare payments.
Officials with the Alaska Native Medical Center and Fairbanks Memorial Hospital, the two Alaska hospitals that received the poorest scores, declined to comment on what factors may have cause their low rankings.
Clover Tiffany, director of communications at the Fairbanks hospital, said they are still "analyzing what the causes are" and added that the penalty could be up to $400,000.
"Of course we're disappointed that our score was what it was but we are committed to improving quality, just like every hospital in the nation," Tiffany said.
Reach reporter Tegan Hanlon at firstname.lastname@example.org.
By TEGAN HANLON