Jan. 2—A recent increase in catheter-associated urinary tract infections (CAUTI) has prompted a federal pledge for increased focus on the issue.

Hospitals had a 9 percent increase in their CAUTI rate—among the most common hospital-acquired infections—in the second quarter of FY13 since FY10, according to the recently released annual report of the U.S. Department of Health and Human Services (HHS). That increase did not bode well for HHS’s goal to reduce the catheter infections at all U.S. hospitals by 20 percent by the end of FY13.

In response, HHS plans to increase its focus on reducing CAUTI rates “through maximizing collaboration, ensuring accuracy in reporting, and identifying regional focus area through data.”

In contrast, HHS appears well on its way to meeting its goal of a 25 percent reduction in deadly central line-associated bloodstream infections. Hospitals reduced central line infections by 19 percent by the second quarter of FY13, according to HHS.

Improper Pay Increases

Another setback for HHS was its recent finding of an increase in the rate of improper Medicare payments to healthcare providers. Improper payments jumped to 10.1 percent in FY13 after three years of steadily declining rates, and the rate of improper payments was higher than the statutorily mandated 10 percent maximum. The FY12 rate was 8.5 percent.

Reducing the improper payment rate was a “key goal” for the Centers for Medicare & Medicaid Services “and efforts are currently in progress to investigate and resolve the drivers causing this increase,” according to the HHS report.

HHS officials argued that the increased error rate did “not necessarily indicate a breakdown in the program’s internal control structure.” Other possible reasons for the increase, according to the HHS report, could include new policies, such as the policy requiring documentation of face-to-face encounters with physicians prior to providing home health services.

“Since it takes time for providers and suppliers to fully implement new policies, especially those with new documentation requirements, it is not unusual to see increases in error rates following the implementation of new policies,” the report stated.

“Administrative and documentation errors,” such as insufficient documentation, account for 63 percent of the errors, and 37 percent are classified as “authentication and medical necessity errors,” which included the provision of medically unnecessary services and incorrect diagnosis coding.

Specific elements of HHS’s response to the error rate increase includes stepped up activity by recovery audit contractors (RACs). For instance, the HHS report cited a growing pilot program that allows RACs to review “certain types of claims that historically have high amounts of improper payments” before payment is sent.

The pilot, which began in September 2012, is credited with saving Medicare about $22.3 million.

Publication Date: Thursday, January 02, 2014