Multiple studies confirm that Medicare’s payment reduction policies for complications has not resulted in reductions in complications.

The CMS policy of withholding additional Medicare payment for mediastinitis was not associated with a reduction in actual infection rates during the first 2 years after policy implementation. Similar findings were associated with catheter-associated urinary tract infections (CAUTIs), which actually continued to rise after Medicare instituted payment reduction policies. Notwithstanding the lack of reduction or production in increased rates of healthcare associated infections, claims-based evidence showed changes in coding for infections but not reduction in infections.


Calderwood MS, et. al., Impact of Medicare's payment policy on mediastinitis following coronary artery bypass graft surgery in US hospitals.Infect Control Hosp Epidemiol. 2014 Feb;35(2):144-51

Schuller K., et. al., Initial impact of Medicare's nonpayment policy on catheter-associated urinary tract infections by hospital characteristics. Health Policy. 2014 Apr;115(2-3):165-71