For the first time ever, the federal government is penalizing more than 700 hospitals across the country for having high rates of things called hospital acquired infections.
Those are potentially avoidable mistakes in health care, like urinary tract infections.
In Connecticut, 14 hospitals are facing the penalty -- and that means they're losing millions of dollars.
The Affordable Care Act is well-known as a law intended to get more people on health insurance. But it also has provisions intended to improve health care itself. This is one of them.
"Basically, the goal is to improve patient safety by penalizing hospitals that have a lot of patient injuries and accidents," said Jordan Rau, a reporter for Kaiser Health News who has covered the issue. He said the law measures two types of common infections from things like catheters and central lines, among other things.
"The way that the law works is the quarter of hospitals that do the worst automatically get penalized and they'll lose one percent of their Medicare payments over the course of the year," Rau said. He added that the data is valuable, but should be taken in context.
"The message is not that these places are death factories, because I don't think that it's that extensive," Rau said. "What it means is that, on the things that they're being measured on patient safety, they have higher numbers of incidents than other hospitals."
In Connecticut, 45 percent of the hospitals that are included in the program were penalized. That's among the highest rates in the nation. They include Bridgeport Hospital, Danbury Hospital, Waterbury Hospital, Hartford Hospital, and Yale-New Haven Hospital.
"The general movement in medical care towards more accountability is a good one. A large proportion of our national budget is spent on health care and we should be held accountable for how that money is spent," said Tom Balcezak, chief medical officer at Yale-New Haven. He's all for accountability and lowering infection rates.
Balcezak said this specific data set has its problems. First of all, its old -- and hospitals like his have improved. Second, it doesn't take a lot of things into account -- like how some hospitals might get less healthy patients. So, the penalty has its problems.
"These kinds of things should be being worked on in institutions, but perhaps the specific measures aren't exactly correct," he said. But even if the measures are off, there's no getting around the penalties. And they're real.
"It's in the millions of dollars... and, for that reason, it's got our attention," said Rocco Orlando, the senior vice president and chief medical officer for Hartford HealthCare. "There's no question that the financial penalty gets people's attention," he said, adding that hospitals like his are working hard to avoid the penalties.
Orlando shares the concern that the data the federal government is using might not be the best measure. Still, he said his organization is already working hard to reduce the kinds of infections that get them penalized -- like urinary tract infections.
"We've got too many urinary tract infections, and we need to drive that down," Orlando said. "So that is a major initiative for us and we are devoting a great deal of time and resources to reducing that rate of infection and we're making some early progress."
Orlando said the penalties are part of a broader trend in healthcare to pay doctors and hospitals not just to manage healthcare -- but to actually improve health outcomes.
"It's very clear we're going to be increasingly paid for getting good results, for avoiding complications, and I think, ultimately, that's a good thing," Orlando said.
Unless lawmakers decide to revisit the Affordable Care Act and strip the provision, the penalty will come back again next year.
This story is part of a partnership with WNPR, Kaiser Health News, and NPR.