Costs of Hospital-Acquired Conditions Not Tracked by CMS: Ventilator-Associated Events

OBJECTIVE

OIG’s body of work on adverse events has identified persistent rates of patient harm across health care settings that continue to cost the Medicare program billions of dollars each year.  CMS has payment policies and programs to prevent higher Medicare reimbursement for care involving common, costly, and readily preventable hospital-acquired conditions (HACs), but OIG has found that few events are captured under these policies because of CMS’s narrow lists of harms.  OIG previously recommended that CMS expand its lists of HACs to better capture such events.  CMS has yet to implement this recommendation and has not updated its lists in nearly a decade.  This study will build on the outstanding recommendation to expand the lists of HACs by examining ventilator-associated events (VAEs)—a prevalent and costly HAC not currently included in CMS’s payment policies.  Our review will determine the incidence of VAEs among hospitalized Medicare patients and its associated costs to Medicare.  This work will provide actionable data to support CMS in aligning payment with quality and safeguarding Medicare dollars.

TIMELINE

• August 15, 2026
  Announced

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