Maui hospital faces funding reduction for poor ratings

MAUI » The head of the Maui Memorial Medical Center says the hospital expects to lose about $600,000 in Medicare funding in the current federal fiscal year after it scored poorly on an Affordable Care Act performance measuring program.

The Maui facility will lose 1 percent of reimbursements it receives directly from Medicare in the rating program covering hospital infections and other ailments, The Maui News reported.

Wes Lo, CEO of the Hawaii Health System Corp.’s Maui Region, said Tuesday hospital officials are still working to determine exactly how much they will lose. Based on last year, Maui Memorial received $62 million in reimbursements from Medicare, putting a 1 percent reduction at about $600,000.

“It’s a bummer; we are not happy,” Lo said. “We need to provide the appropriate resources for them… . to support the doctors and nurses better.”

The rating program scored hospitals on several categories, including patient safety indicators, central-line associated bloodstream infections, catheter associated urinary tract infections and surgical-site infections. The reporting periods differed with the category, but in total covered July 2012 to December 2014.

Maui Memorial scored near the bottom in all categories but the central-line-associated bloodstream infections category, which was in line with the national average.

Lo said that not all of the low scores Maui Memorial received were related to care. Hospital officials in their review also noted problems with coding and physician documentation.

In the ranking, Maui Memorial’s Hospital-Acquired Condition score fell in the bottom quarter of hospitals receiving Medicare payments nationwide and was the lowest-rated hospital in the state. Hospitals in the bottom 25 percent were subject to payment reductions.

Hospital officials attribute some of the low scores to the hospital’s switch to electronic filing in March 2014. Lo said making the change to electronic filing was needed, as well as mandated by the Affordable Care Act, but “we knew we would suffer quality.”

Lo said the hospital is working to make improvements. It has implemented a clinical documentation improvement program, a new catheter insertion checklist, new types of catheters and new protocols, he said.

Despite the estimated cut to Medicare funding, the hospital recently received notification of an additional $1 million in reimbursements for rural hospitals due to reporting errors, Lo said.

“Overall (losing) $600,000 is a bummer,” said Lo. “On the other hand, we have some gains, and we are performing above budget and we are getting this other $1 million.”