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Md. hospitals penalized for preventable complications

Nine Maryland hospitals, including the University of Maryland Medical Center, have been handed financial penalties this year from the state's rate-setting commission because they had costly or higher-than-average rates of preventable patient complications.

The effort by the Maryland Health Services Cost Review Commission, which sets the rates that hospitals can charge, is designed to improve patient safety and lower health care costs by linking hospital performance with their payments. The Maryland Hospital Acquired Conditions initiative launched in 2009, but this is the first year that hospitals have seen a reduction in revenue based on where they fall against state averages. The news of the penalties was first reported by Kaiser Health News.

The program keeps track of 49 complications such as blood clots, urinary tract infections, kidney failure and other infections, and sets a statewide average. Hospitals that perform worse than average or incur higher costs are penalized and those that score better than average and show a cost savings get a financial boost.

Of the state's 45 hospitals tracked from July 2009 to June 2010, 23 scored better than average. Nine hospitals are seeing a $2.1 million cut in their allowed rate increases this year. Those hospitals are: Prince George's Hospital Center, Doctors Community Hospital, Laurel Regional Hospital, Union Hospital in Cecil County, Montgomery General Hospital, Civista Medical Center in Southern Maryland, Shady Grove Adventist Hospital, Washington Adventist Hospital and University of Maryland Medical Center.

St. Joseph Medical Center in Towson also had a higher-than-average rate, but the complications weren't costly enough to incur penalties.

Officials at the University of Maryland, which has seen a cut of $678,000, said they have worked to decrease the number of central line bloodstream infections since the commission's reporting period. Those infections decreased 70 percent between July and September of last year, said Mary Lynn Carver, a spokeswoman for the medical center.

"The University of Maryland Medical Center is looking at every possible way we can drive down complication rates in our unique patient population," she said. "UMMC has a high concentration of very complex cases, and a large number of intensive care units in addition to trauma."

Still, the commission adjusts its ranking for different types of patients, accounting for hospitals that treat large number of traumas, where complications re more likely, for instance.

Robert Murray, executive director of the rate-setting body, said the program is reducing complications and ratcheting down costs. In 2009, there were 55,000 complications statewide. That figure dropped to 49,000 last year, nearly a 12 percent reduction, which saved an estimated $62 million in health care costs, said Murray.

"It's back to that equation of what we are trying to do — show patients and people who pay for health care where are they getting the best value. That's a combination of efficiency and quality," Murray said. "This is one measure of quality."

Carmela Coyle, president of the Maryland Hospital Association, said hospitals should take comfort in the overall reduction of complications.

She said: "Maryland's hospitals are among the quality leaders in the nation, and a 12 percent drop in the number of potentially preventable complications is something to be proud of, as are all the efforts hospitals are involved in to make patient care safer."

Baltimore Sun reporter Meredith Cohn and Kaiser Health News contributed to this article.

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