Teresa Waters, PhD, associate professor of Preventive Medicine at UTHSC,has been awarded a grant totaling $793,056 from the Agency for Healthcare Research and Quality, part of the Department of Health and Human Services.
Teresa Waters, PhD, associate professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center (UTHSC), has been awarded a grant totaling $793,056 from the Agency for Healthcare Research and Quality, part of the Department of Health and Human Services. The award will fund her two-year study titled “Responses to Medicare’s Nonpayment for Preventable Hospital Complications.”
Dr. Waters’ research project will examine the impact of a new Medicare payment policy on the quality of hospital care delivered to Medicare beneficiaries. On October 1, 2008, Medicare implemented a policy that denies payments to hospitals for any additional care associated with eight complications of medical care deemed preventable. These eight “hospital acquired conditions” include such complications as an object left in patient during surgery, blood incompatibility, catheter-associated urinary tract infection, vascular-catheter-associated infections and inpatient falls. Medicare believes that its nonpayment policy will cut costs and improve quality of care. This new policy is unusual, however, because it is the first major use of negative incentives by Medicare.
“I’m very excited that the Agency for Healthcare Research and Quality has chosen to fund this research because we really need timely information on the impact of Medicare’s new nonpayment policy,” said Dr. Waters. “Other insurers often follow Medicare’s lead, and Medicare is likely to consider expanding this payment change to additional areas of care.”
Dr. Waters will lead a team of researchers from UTHSC, the University of Florida, Virginia Commonwealth University, Kansas University Medical Center, and the University of Iowa in examining whether the policy has been effective in reducing targeted complications and how specific hospital circumstances have affected responses to the policy. The results will inform Medicare and other insurers about those aspects of the policy that are working as intended and those that are not , and can be used to tailor future payment policy changes.
The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. HHS represents almost a quarter of all federal outlays, and it administers more grant dollars than all other federal agencies combined. HHS’ Medicare Program is the nation’s largest health insurer, handling more than one billion claims per year. Medicare and Medicaid together provide health care insurance for one in four Americans. For more information, visit www.hhs.gov.