Hospital-Acquired Infections Under Pay-for-Performance Systems: an Administrative Perspective on Management and Change

  • Rebecca A. VokesEmail author
  • Gonzalo Bearman
  • Gloria J. Bazzoli
Healthcare Associated Infections (G Bearman and D Morgan, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Healthcare Associated Infections


Purpose of Review

The purpose of this review is to explore the impact of hospital-acquired infection on payment under pay-for-performance systems, and provide perspective on the role of administrators in infection prevention.

Recent Findings

Hospital-acquired infections continue to pose a serious threat to patient safety and to the fiscal viability of healthcare facilities under pay-for-performance systems. There is mixed evidence that use of pay-for-performance systems leads to prevention of hospital-acquired conditions. Use of evidence-based guidelines has been shown to reduce hospital-acquired infections.


Increasing use of pay-for-performance (PFP) systems results in potential loss of reimbursement for healthcare organizations that fail to prevent hospital-acquired infections (HAI). Healthcare administrators must work with front-line providers and infection control staff to establish and maintain evidence-based infection prevention policy. Additionally, infection control policy should be regularly updated to reflect best practices, and proper change management techniques should be employed in order to mobilize and empower staff to increase their ability to prevent hospital-acquired infections.


Hospital-acquired infection Change management Pay for performance Healthcare administration Healthcare management Alternative payment models Hospital-acquired condition CMS Medicare reimbursement Medicaid reimbursement Hospital reimbursement Nosocomial condition CLABSI Kotter method Kotter change management Preventing hospital infection Infection prevention Hospital management Organizational change CMS payment Infection prevention program Horizontal vs vertical intervention Horizontal infection control Vertical infection control 



The authors would like to thank Michele Fleming, MSN, RN, CIC, for her review of this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rebecca A. Vokes
    • 1
    Email author
  • Gonzalo Bearman
    • 2
  • Gloria J. Bazzoli
    • 1
  1. 1.Department of Health AdministrationVirginia Commonwealth UniversityRichmondUSA
  2. 2.VCU HealthRichmondUSA

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