Three Kansas City Area Hospitals Get Dinged By Medicare For High Complication Rates | KCUR

Three Kansas City Area Hospitals Get Dinged By Medicare For High Complication Rates

Mar 8, 2019

Three Kansas City-area hospitals are among 17 in Missouri and seven in Kansas that are being penalized by Medicare this year for high infection and patient-injury rates.

Truman Medical Centers, Research Medical Center and Belton Medical Center will see their Medicare payments reduced by 1 percent because of high rates of complications. It’s the fifth year in a row Truman has been penalized.

The government began imposing the penalties five years ago under the Affordable Care Act as part of an ongoing effort to improve patient care. The quarter of hospitals nationwide with the highest rates get punished – even if their records have improved over the previous year.

Altogether, 800 general hospitals nationwide will see their Medicare payments cut. Pediatric, specialty, veterans and mental hospitals are not included.

The penalties are assessed based on rates of infections, blood clots, cases of sepsis, bedsores, hip fractures and other complications.

A frequent criticism of the program is that it doesn't take into account hospitals that treat the most fragile patients and penalizes those that are the most diligent about testing for infections and other complications.

Academic medical centers like Truman often fare less well under the program because they tend to have higher numbers of patients with pre-existing infections or multiple conditions or both.

Leslie Carto, a spokeswoman for Truman Medical Centers, noted that a large percentage of that hospital’s patients have multiple chronic diseases.

“While Truman Medical Centers supports transparency and a system allowing patients and the community to have a complete understanding of the health care system they choose, we agree with groups like America’s Essential Hospitals and the American Hospital Association when they point out [the Centers for Medicare & Medicaid Services] does not fully take into account factors like concurring chronic disease, health literacy, access to transportation, difficulty obtaining medicine and other socioeconomic factors – which can send a misleading message to consumers,” Carto said in a statement.

A significant proportion of Truman's patients are uninsured or on Medicaid. Carto said the hospital expects to provide nearly $150 million in uncompensated care this year.

A spokeswoman for HCA Midwest Health, which owns Research and Belton medical centers, did not immediately provide a comment. 

The penalties are assessed under the government’s Hospital-Acquired Condition Reduction Program (HAC), one of three mandatory pay-for-performance programs created under the Affordable Care Act. The other programs penalize hospitals with high readmissions rates and award bonuses or penalties based on various quality measures.

Here are the 24 Missouri and Kansas hospitals being penalized this year:

  • SSM Health St. Joseph Hospital-St. Charles
  • SSM Health St. Mary’s Hospital-Jefferson City, Jefferson City, Mo.
  • Texas County Memorial Hospital, Houston, Mo.
  • Research Medical Center, Kansas City, Mo.
  • Truman Medical Centers Hospital Hill, Kansas City, Mo.
  • Mercy Hospital Lebanon, Lebanon, Mo.
  • SSM Health Saint Louis University Hospital, St. Louis, Mo.
  • Southeast Hospital, Cape Girardeau, Mo.
  • University of Missouri Health Care, Columbia, Mo.
  • Fitzgibbon Hospital, Marshall, Mo.
  • Christian Hospital Northeast-Northwest, St. Louis, Mo.
  • Barnes-Jewish St. Peters Hospital, St. Peters, Mo.
  • Citizens Memorial Hospital, Bolivar, Mo.
  • SSM Health Saint Joseph Hospital-Lake Saint Louis, Lake St. Louis, Mo.
  • St. Alexius Hospital, St. Louis, Mo.
  • Belton Regional Medical Center, Belton, Mo.
  • Progress West Hospital, O’Fallon, Mo.
  • Via Christi Hospital, Pittsburg, Kan.
  • Geary Community Hospital, Junction City, Kan.
  • Stormont Vail Hospital, Topeka, Kan.
  • McPherson Hospital, McPherson, Kan.
  • Saint Luke’s Cushing Hospital, Leavenworth, Kan.
  • Salina Surgical Hospital, Salina, Kan.
  • Via Christi Hospital St. Teresa, Wichita, Kan.

Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.