Medicare is lowering all its payments to 758 hospitals by 1% over the course of the federal fiscal year. Hospitals were measured on their rates of sepsis, hip fractures, and infections for patients with central lines inserted into veins, urinary catheters and incisions from colon surgeries and hysterectomies. The penalties represent a $364 million loss for the affected hospitals and are based on the frequency assessments of several types of hospital-acquired conditions (HAC.)

Some believe the sanctions are a just and fair way to ensure that hospitals meet safety standards and guidelines. They also argue that the penalties don’t go far enough to ensure that hospitals change their behaviors, and that the list of HACs a hospital can be punished for should be expanded.

However, others are worried that the penalties are being enacted against places that making steps toward meeting safety goals but haven’t caught up with other facilities. They point to a paper in The Journal of the American Medical Association, which found that the most of the hospitals penalized had positive qualities, such as a higher nurse to patient ratio, more extensive trauma centers, and Joint Commission accreditation.