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Comparing the Hospital-Acquired Condition Reduction Program and the Accreditation of Cancer Program: A Cross-sectional Study.
Inquiry. 2018 Jan-Dec; 55:46958018770294.I

Abstract

Under the Hospital-Acquired Condition Reduction Program (HACRP), introduced by the Affordable Care Act, the Centers for Medicare and Medicaid must reduce reimbursement by 1% for hospitals that rank among the lowest performing quartile in regard to hospital-acquired conditions (HACs). This study seeks to determine whether Accredited Cancer Program (ACP) hospitals (as defined by the American College of Surgeons) score differently on the HACRP metrics than nonaccredited cancer program hospitals. This study uses data from the 2014 American Hospital Association Annual Survey database, the 2014 Area Health Resource File, the 2014 Medicare Final Rule Standardizing File, and the FY2017 HACRP database (Medicare Hospital Compare Database). The association between ACPs, HACs, and market characteristics is assessed through multinomial logistic regression analysis. Odds ratios and 95% confidence intervals are reported. Accredited cancer hospitals have a greater risk of scoring in the Worse outcome category of HAC scores, vs Middle or Better outcomes, compared with nonaccredited cancer hospitals. Despite this, they do not have greater odds of incurring a payment reduction under the HACRP measurement system. While ACP hospitals can likely improve scores, questions concerning the consistency of the message between ACP hospital quality and HACRP quality need further evaluation to determine potential gaps or issues in the structure or measurement. ACP hospitals should seek to improve scores on domain 2 measures. Although ACP hospitals do likely see more complex patients, additional efforts to reduce surgical site infections and related HACs should be evaluated and incorporated into required quality improvement efforts. From a policy perspective, policy makers should carefully evaluate the measures utilized in the HACPR.

Authors+Show Affiliations

1 Mayo Clinic, Jacksonville, FL, USA.1 Mayo Clinic, Jacksonville, FL, USA.1 Mayo Clinic, Jacksonville, FL, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29806532

Citation

Spaulding, Aaron, et al. "Comparing the Hospital-Acquired Condition Reduction Program and the Accreditation of Cancer Program: a Cross-sectional Study." Inquiry : a Journal of Medical Care Organization, Provision and Financing, vol. 55, 2018, p. 46958018770294.
Spaulding A, Paul R, Colibaseanu D. Comparing the Hospital-Acquired Condition Reduction Program and the Accreditation of Cancer Program: A Cross-sectional Study. Inquiry. 2018;55:46958018770294.
Spaulding, A., Paul, R., & Colibaseanu, D. (2018). Comparing the Hospital-Acquired Condition Reduction Program and the Accreditation of Cancer Program: A Cross-sectional Study. Inquiry : a Journal of Medical Care Organization, Provision and Financing, 55, 46958018770294. https://doi.org/10.1177/0046958018770294
Spaulding A, Paul R, Colibaseanu D. Comparing the Hospital-Acquired Condition Reduction Program and the Accreditation of Cancer Program: a Cross-sectional Study. Inquiry. 2018 Jan-Dec;55:46958018770294. PubMed PMID: 29806532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing the Hospital-Acquired Condition Reduction Program and the Accreditation of Cancer Program: A Cross-sectional Study. AU - Spaulding,Aaron, AU - Paul,Rachel, AU - Colibaseanu,Dorin, PY - 2018/5/29/entrez PY - 2018/5/29/pubmed PY - 2018/12/12/medline KW - American Hospital Association KW - Patient Protection and Affordable Care Act KW - cancer care facilities KW - iatrogenic disease KW - multinomial logistic regression SP - 46958018770294 EP - 46958018770294 JF - Inquiry : a journal of medical care organization, provision and financing JO - Inquiry VL - 55 N2 - Under the Hospital-Acquired Condition Reduction Program (HACRP), introduced by the Affordable Care Act, the Centers for Medicare and Medicaid must reduce reimbursement by 1% for hospitals that rank among the lowest performing quartile in regard to hospital-acquired conditions (HACs). This study seeks to determine whether Accredited Cancer Program (ACP) hospitals (as defined by the American College of Surgeons) score differently on the HACRP metrics than nonaccredited cancer program hospitals. This study uses data from the 2014 American Hospital Association Annual Survey database, the 2014 Area Health Resource File, the 2014 Medicare Final Rule Standardizing File, and the FY2017 HACRP database (Medicare Hospital Compare Database). The association between ACPs, HACs, and market characteristics is assessed through multinomial logistic regression analysis. Odds ratios and 95% confidence intervals are reported. Accredited cancer hospitals have a greater risk of scoring in the Worse outcome category of HAC scores, vs Middle or Better outcomes, compared with nonaccredited cancer hospitals. Despite this, they do not have greater odds of incurring a payment reduction under the HACRP measurement system. While ACP hospitals can likely improve scores, questions concerning the consistency of the message between ACP hospital quality and HACRP quality need further evaluation to determine potential gaps or issues in the structure or measurement. ACP hospitals should seek to improve scores on domain 2 measures. Although ACP hospitals do likely see more complex patients, additional efforts to reduce surgical site infections and related HACs should be evaluated and incorporated into required quality improvement efforts. From a policy perspective, policy makers should carefully evaluate the measures utilized in the HACPR. SN - 0046-9580 UR - https://www.unboundmedicine.com/medline/citation/29806532/Comparing_the_Hospital_Acquired_Condition_Reduction_Program_and_the_Accreditation_of_Cancer_Program:_A_Cross_sectional_Study_ L2 - http://journals.sagepub.com/doi/full/10.1177/0046958018770294?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -