Hospital-Acquired Conditions

Last July (2008) Medicare identified 10 categories of Hospital-Acquired Conditions (HACs). HACs present as: (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence‑based guidelines.
The 10 categories of HACs include (I’ve omitted subsets of conditions—see the Medicare link for more detail) :
1. Foreign Object Retained After Surgery
2. Air Embolism
3. Blood Incompatibility
4. Stage III and IV Pressure Ulcers
5. Falls and Trauma
6. Manifestations of Poor Glycemic Control
7. Catheter-Associated Urinary Tract Infection (UTI)
8. Vascular Catheter-Associated Infection
9. Surgical Site Infection Following:
o Coronary Artery Bypass Graft (CABG) - Mediastinitis
o Bariatric Surgery
o Orthopedic Procedures
10. Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE)

Is this new information for you, or are you currently trying to cope with this new ruling and its payment implications, implemented in October 2008?

In the next post, I’ll discuss implications for costs, quality, revenues and business plans.