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Health

Feds Penalize 8 Maine Hospitals

PORTLAND, Maine — Eight Maine hospitals have been found to rank among the nation's worst when it comes to avoidable mistakes could be harmful to patients. And as a result, they will have their Medicare payments docked.

More Maine hospitals are being penalized this year compared to last. The program is one of the health care reforms under the Affordable Care Act that shifts reimbursements from the volume of care delivered to the quality of care delivered.

Those potentially avoidable mistakes are called hospital-acquired conditions, or HACs, conditions that patients develop after being admitted to a hospital for other reasons. Things like central-line bloodstream infections, urinary tract infections from catheters and a category called "serious complications," which covers a range of conditions from blood clots to bed sores.

Hospitals receive scores on a scale of 1-10, with 10 being the worst. Maine Medical Center in Portland has the state's worst score: 9.75.

"Clearly, we're very concerned about the implication, or the truth, that we're harming patients unnecessarily in the sense that we could prevent some of these infections," says Dr. Josh Cutler, vice president of quality and safety at Maine Med.

Because Maine Medical Center scored in the bottom percentile of all hospitals, it'll lose 1 percent of Medicare payments for the next fiscal year. Cutler says that adds up to a $1.5 million hit.

Maine General in Augusta got the second worst score in the state with a nine.

"Our surgical site infection is quite variable, I will have to be honest about, in the sense that we do well for awhile, and then we seem to slip," says Steve Diaz, the chief medical officer at Maine General.

He says the score will cost the hospital up to about $450,000 in reduced Medicare payments.

More Maine hospitals made the penalty list this year, which Andy Webber of the Maine Health Management Coalition finds troubling.

"It is a bit concerning that the list went up," he says. "We went from six to eight hospitals."

But Webber says ultimately, programs like this one — called the Hospital Acquired Condition Reduction Program — should boost quality at state hospitals.

"Greater transparency — making public the information, you accelerate the incentives for increasing provider performance," he says.

Webber notes that two hospitals dropped off the penalty list this year: Inland Hospital and The Aroostook Medical Center. And both Maine General and Maine Medical Center say they're doing better than the current scores reflect, because there's a lag in the data used.

Diaz says so far this year, Maine General has had only 5 catheter infections, compared with 26 two years ago. Cutler says Maine Med also reduced its catheter infection rates this year.

"Very markedly actually, decreasing the rates of infection by nearly half," he says.

And Cutler says that the Hospital Acquired Condition Reduction Program is an effective tool to reduce avoidable mistakes.

"Connecting reimbursement penalties to performance on issues that really result in patient harm is a great way to focus health care professionals' attention on them," he says.

Both Cutler and Diaz say while hospitals work hard to improve quality, patients can also play a role. They recommend, for example, that patients not be shy about making sure health care providers wash their hands when they enter their room.