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NPIAP Calls for Pressure Injury Funding Changes 2021-2022
A trio of professional organizations in the wound care and prevention fields have asked the Centers for Medicare & Medicaid Services (CMS) to reconsider its reimburse- ment policies for pressure injuries that develop while patients are hospitalized.
The National Pressure Injury Advisory Panel (NPIAP), the Association for the Advancement of Wound Care (AAWC), and the Wound, Ostomy and Continence Nurses Society (WOCN) sent
a letter — A Collaborative Call
for Changes in Reimbursement Policies to Achieve Improvements in Hospital Safety Related to Pressure Injury — to the Journal of Patient Safety. The Journal published the letter in its June 2021 edition.
In the letter, the three organiza- tions noted that in February 2020, CMS analyzed the frequencies of 16 hospital-acquired conditions and identified pressure injuries as the only one that had significantly increased in number.
NPIAP, AAWC, and WOCN suggested that incidences of pressure injuries are increasing among hospitalized patients because CMS is financially pres- suring hospitals to reduce hospi- tal-acquired conditions overall — but is not requiring hospitals
to reduce incidences for each condition that’s being tracked. Because pressure injuries are
relatively costly for hospitals to prevent, the NPIAP/AAWC/WOCN letter suggested that hospitals are focusing on reducing the incidences of hospital-acquired conditions that are less costly to prevent. “Not having to improve rates of all conditions to avoid a
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penalty, hospitals could prioritize preventing outcomes that are least labor intensive or [most] cost efficient,” the letter said.
The organizations recom- mended a three-step reimburse- ment policy overhaul. It involves rewarding hospitals that reduce occurrences of all hospital-ac- quired conditions, including pressure injuries; sharing pressure injury prevention costs between CMS and hospitals; and devel- oping reimbursement policies that encourage hospitals to compete to provide the best patient outcomes.
To read the letter, go
to reimbursementpolicychanges.
Stage 3 and 4 pressure injuries after hospital admission are clas- sified by CMS as “never” events — “Serious and costly errors in the provision of healthcare services that should never happen.” Other never events include performing surgery on the wrong body part, and patient death or serious injury resulting from use of restraints or bedrails. m
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