Medicare to lower payments to 15 New Jersey hospitals

Medicare is reducing payments for this year to 15 New Jersey hospitals with higher than average rates of hospital-acquired infections, falls, blood clots or other injuries suffered by patients.

The penalties are intended as a financial incentive to encourage hospitals to improve patient care, and were included in the Affordable Care Act.

Hospitals that will see their payments from Medicare lowered include Hackensack University Medical Center, Robert Wood Johnson University Hospital, Chilton Medical Center in Pompton Plains, Meadowlands Medical Center in Secaucus and HackensackUMC-Mountainside in Montclair.

New Jersey’s performance this year is the best in the four years the penalties have been imposed. By law, the federal program is required to penalize the lowest-performing quarter of hospitals nationwide. That included 23 New Jersey hospitals in 2015, 21 in 2016 and 26 hospitals in 2017.

“It's gratifying to see the consistent improvement in New Jersey because we've been focused very intently on these patient safety issues,” said Kerry McKean Kelly, a spokeswoman for the New Jersey Hospital Association.

Working with the association, hospitals have reduced adverse drug reactions by 55 percent; patient falls by 43 percent; and infections in central line catheters by 46 percent, she said. Hospital efforts in those areas over the last four years have averted more than 77,000 such complications, she said.

Because the law requires penalties for one-quarter of the nation’s hospitals, gains made in the overall quality of care are not recognized – one reason that hospitals criticize this approach.

“A hospital could be making good progress in patient safety, and still get dinged,” said Kelly. In addition, hospitals treating sicker patients may have higher rates of complications, she said.

Three hospitals in the state have been penalized all four years: University Hospital in Newark, Robert Wood Johnson University Hospital in New Brunswick and Capital Health Medical Center-Hopewell. Nationwide, teaching hospitals are more likely to receive penalties than other hospitals, in part because they treat more complex patients.

Ten hospitals in the state have been penalized three out of four years, including Hackensack and HackensackUMC-Mountainside; Chilton; Meadowlands; Lourdes Medical Center of Burlington County; Cooper University Hospital in Camden; CentraState Medical Center in Freehold; Overlook Medical Center in Summit; Trinitas Regional Medical Center in Elizabeth; and Robert Wood Johnson University Hospital-Hamilton.

Medicare penalties are not the only source of information about hospital safety.

The Leapfrog Group, a private non-profit to which hospitals voluntarily submit data, also rates hospital safety. Two of the hospitals penalized, Hackensack and Bayshore Medical Center in Holmdel, received "A"s for safety from Leapfrog this fall.

The factors considered in assessing the penalties include bedsores, falls that lead to hip fractures, sepsis, surgical-wound infection or rupture, blood clots in the lungs or deep-vein thrombosis, hemorrhages, infections in urinary catheters and central-line catheters, and infection with C. difficile, a difficult to treat intestinal bacteria, or methicillin resistant staphylococcus.

More: Fight against sepsis saved 400 in a year, N.J. hospitals say

More: OpEd: Hospital ratings: imperfect, but still needed

Medicare payments to the affected hospitals will be lowered retroactively to Oct. 1, 2017, through Sept. 30, 2018.

Medicare also penalizes hospitals that have high rates of patients readmitted within 30 days of being discharged. Those penalties, announced earlier in the year, affect 95 percent of New Jersey hospitals.

“The bottom line is this,” said Kelly. “Patient care is safer than ever in New Jersey hospitals, but we know there's always more work to be done.”