No payment for preventable complications: reviewing the early literature for content, guidance, and impressions

Abstract

In 2008, the Centers for Medicare & Medicaid Services (CMS) implemented a policy of not paying hospitals for the care of several preventable hospital-acquired conditions. The CMS policy is a unique value-based purchasing initiative because it relies on penalties rather than on rewards. Because of its novelty, less is known in advance about how this type of payment approach might work, get implemented, or be viewed by stakeholders in health care. As a result, the early published literature focusing on the CMS policy may serve as an important frame of reference among managers, policy makers, and researchers for guiding attitudes and behaviors. This review examines over an initial 3-year period academic and trade articles addressing the CMS policy to gain the impressions, guidance, and content provided in this literature. Key findings include an inordinately small number of articles focused on the new CMS policy; little original research or empirical prediction on CMS policy implementation and outcomes; a highly opinionated, non-evidence-based literature; a literature less able to address the policy impact for specific preventable complications or hospital settings; and a high percentage of articles making inconsistent, broad-based linkages between the CMS policy and specific quality improvement initiatives that potentially limit the policy's long-term acceptance as an improvement strategy.