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1Running head: HOSPITAL ACQUIRED CONDITION Hospital Acquired Condition Reduction ProgramTan CastroHealth Policy, NURS 6205George Washington University10 March 2020
2HOSPITAL ACQUIRED CONDITION OVERVIEW OF HACRPThe Hospital Acquired Condition Reduction Program, also known as HACRP, is a pay-for-performance program established by the Affordable Care Act and Patient Protection (CMS, 2020). They require that the Centers for Medicare and Medicaid services (CMS) compile the total HAC score per each hospital to identify the worst-performing quartile of all hospitals. This allows the Secretary of Health and Human Services (HHS) to deduct payments from hospitals that rank in the bottom 25 percent in accordance with HAC quality measures (CMS, 2020). These conditions are considered to be acquired because they have developed after the patient has been admitted. If a patient has been admitted for pneumonia and developed a catheter-associated urinary infection (CAUTI), it is classified as nosocomial infection which is a subcategory of HAC (Brooks, 2017). For fiscal year 2020, the HAC score is based on data for six main criteria. These include clostridium difficile infection (CDI), central line-associated bloodstream infection (CLABSI), surgical site infection (SSI), catheter-associated urinary infection (CAUTI), Methicillin-resistant Staphylococcus aureus (MRSA), and CMS recalibrated patient safety indicator (PSI) 90 (CMS, 2020). Patient Safety Indicator (PSI) 90 measures 10 components. These include pressure ulcers, iatrogenic pneumothorax, perioperative hemorrhage, hematoma, perioperative acute kidney injury requiring dialysis, respiratory failure, pulmonary embolism or deep vein thrombosis, sepsis, wound dehiscence, and unrecognized abdominopelvic accidental puncture (CMS, 2020). CMS utilizes a 2-year performance period for CMS PSI calculations and calculates each hospital’s total HAC score (CMS, 2020). They will then determine the worse performing groups by combining the hospital’s performance on every measure into one total score. If the hospital’s total HAC score is more than 75%, CMS will deduct 1% of their yearly inpatient Medicare payment. CMS gives hospitals 30 days to review their HAC data, submit questions about the results, and request a correction in scoring if needed (CMS, 2020). Finally,
3HOSPITAL ACQUIRED CONDITION after correcting and reviewing the scores, CMS will publicly report each hospitals’ HACRP data on Hospital Compare.HOW HACRP INTENDS TO ACHIVE HIGHER VALUEThe HACRP intend to achieve higher value by encouraging better practice, reducing costs, increasing quality and diminishing healthcare disparities (Hamadi et al., 2019). For instance, HACs are harmful and can cause adverse health effects in the course of a patient treatment. It carries the potential of causing additional pain, distress, and more days in the hospital which can be economically taxing. If hospitals are not adhering to proper procedures or protocols as well as not being proactive at lowering the rates of HAC, cost will continue to rise.