Nonpayment for Hospital-Acquired UTIs: No Significant Change in Physician Behavior

In October 2008, in an attempt to incentivize quality, the Centers for Medicare and Medicaid Services (CMS) implemented a policy to withhold reimbursement for treating nosocomial infections, including catheter-associated urinary tract infections (UTIs). Since this nonpayment list does not include preexisting UTIs, some people have feared that the policy would lead to a dramatic increase in infection screening at hospital admission and more liberal use of antibiotics.

Using data from a research network of 39 hospitals, investigators compared the frequency of urine cultures on admission and use of antimicrobials commonly prescribed for UTIs in the 16 months before and 17 months after institution of the CMS policy. Data on wound cultures within…