Germ shed management in the United States

Abstract

The US Medicare program reimburses only for discrete treatments of individuals with infections, but fails to pay for infection control or antibiotic stewardship antibiotic stewardship more generally. By focusing solely on discrete hospitals and patients, Medicare ignores the larger epidemiological reality-that hospitals, nursing homes and other institutions operate within a germ shed. Under current Medicare rules, institutions that invest in infection control or antibiotic stewardship antibiotic stewardship may actually lose money and benefit rival firms in the market. In effect, current Medicare rules subsidize MRSA MRSA pollution.