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Research Articles

Monitoring and Reporting Hospital-Acquired Conditions: A Federalist Approach

Many states use the collected data on Hospital Acquired Conditions (HAC) and other serious adverse events for quality improvement initiatives and to provide greater transparency through public reporting. Although innovative and partially influenced by Medicare’s HAC program, these initiatives suggest an opportunity to develop a national reporting system template with standard definitions, methodology, and reporting.


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Trends In Complicated Newborn Hospital Stays & Costs, 2002–2009: Implications For The Future

Study of data on newborn hospital stays showed that complicated births billed to Medicaid increased from 2002 to 2009. Policies to prevent common birth complications have the potential to reduce costs for public programs and improve birth outcomes.

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Effect of Erythropoiesis-Stimulating Agent Policy Decisions on Off-Label Use in Myelodysplastic Syndromes

In 2007, the U.S. Food and Drug Administration released safety warnings about a treatment involving drugs that stimulate the bone marrow to produce blood cells for patients with myelodysplastic syndromes (MDS)—specific blood-related forms of cancer. The warnings discouraged the treatments’ use in non-MDS forms of cancer. The Centers for Medicare & Medicaid Services restricted the coverage of ESAs for Medicare non-MDS cancer patients. The warnings and restriction resulted in an unanticipated lowering of ESA use in Medicare MDS patients by 7.9% by the first half of 2008. Two out of three MDS treatment guidelines examined had worsened in the same period.

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The Impact of Hospital-Acquired Conditions on Medicare Program Payments

Researchers find that certain conditions acquired by Medicare patients during hospital stays cost the Medicare program over $146 million per year more than if those conditions were prevented. Improving care quality in hospitals by applying evidence-based guidelines could prevent such conditions and reduce Medicare costs.

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HAC-POA Policy Effects on Hospitals, Other Payers, and Patients

The CMS Hospital-Acquired Conditions-Present on Admission (HAC-POA) policy resulted in improved hospital safety culture, increased staffing teamwork, more thorough coding documentation, and improved adherence to clinical guidelines within the first three years of implementation. Financial impact of the policy to hospitals and insurers was viewed as minimal.

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Embry Howell, Ashley Palmer, Sarah Benatar, and Bowen Garrett
Ravi Sharma, Lydie A. Lebrun-Harris, Quyen Ngo-Metzger
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Jayasree Basu & Lee Rivers Mobley
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Steven A. Blackwell et al.
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M.S. Vaughan-Sarrazin, X. Lu,, P. Cram
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