THE COST OF INFECTION

The incidence of infections acquired during hospitalization, contributes to an additional annual estimated $45 billion in direct hospital costs. Medicare, Medicaid and some insurance companies no longer pay for some healthcare acquired infections (HAIs). iGuard helps organizations focus on prevention with safe, cost effective solutions. Controlling the spread of infection will create a safe environment. Investing in infection prevention will pay off.

HAIs are the 4th leading cause of death and cost healthcare over $7 billion dollars annually.

Estimated Cost of HAIs

Infection Rate (x/100 Admissions) Annual Total Infections Annual Cost of Infection Annual Total Cost of Stay
Below Average = 1 250 $3,818,750 $6,475,750
Average = 4.5 1,125 $17,184,375 $29,140,875
Above Average = 5.0 1,250 $19,093,750 $32,378,750

Admissions = 25,000 patients
Average Cost of Infection = $15,275
Average Cost of Stay = $25,903

36% More Revenue at Risk

Program 2015
% Payment at Risk
2015
Revenue at Risk
2016
% Payment at Risk
2016
Revenue at Risk
Infection reporting to NHSN 2% $1,000,000 2% $1,000,000
Value-based Purchasing 1% $500,000 1.5% $750,000
Readmissions 1% $500,000 3% $1,500,000
Bottom quartile of infections N/A N/A 1% $20,000
Total payment at risk $2,020,000 $3,770,000
Cost of extended stay due to HAI $2,800,000 $2,800,000
Total direct costs and penalties $4,820,000 $6,577,000

Source: Becker’s Hospital Review, A. Boris, March 15, 2013, A Revenue Leak Soon Turns to Flood
Assumptions: 250 Bed Hospital, 10,000 Admissions, 4% Infection rate, 7 days extended stay

 

Long Term Care Rehab Patient; Presents as C. diff Symptomatic on Day 8 of Part A Stay

Day 1 – 7 Reimbursement Rate (Ultra High Rehab RUGS Category RUX) $849/day
Facility Reimbursement Revenues (7 days at RUX rate) $5,943
C. diff Isolation (Days 8 – 15) Look-back determines new rate
Facility Eligible Reimbursement(Based on Look-Back Classification; Clinical Complex RUGS Category CE1) $326/day
Facility Adjusted Reimbursement Revenues (7 days isolation) $2,282
Lost Reimbursement Revenues (Based on Adjusted Eligible Rate) ($3,661)
Loss for year based on 1 episode per month ($43,932)