The Centers for Medicare & Medicaid Services Reimbursement Policy and Nursing-Sensitive Adverse Patient Outcomes

Abstract

The Centers for Medicare & Medicaid Services (CMS) reimbursement policy identified 11 preventable adverse outcomes. Of these 11 patient outcomes, four (severe pressure ulcers, falls and trauma, catheter-associated urinary tract infections, and vascular catheter-associated infections) are considered nursing sensitive quality outcomes that can be decreased with greater and better nursing care. A cross-sectional study examined the CMS reimbursement policy focusing on nursing-sensitive adverse patient outcomes. The percentage of Medicare patients served as a proxy for a measure of the CMS changes in reimbursement. The CMS reimbursement policy measured by the proxy variable was not related to a reduction of the four adverse outcomes.