Boston University School of Law

Germ Shed Management in the United States

Kevin Outterson
BU Law

Olga Yevtukhova
BU School of Public Health

Germ Shed Management in the United States, in ANTIBIOTIC POLICIES: CONTROLLING
HOSPITAL-ASSOCIATED INFECTION (Ian M. Gould and Jos van der Meer, eds., Springer, 2011)

Boston University School of Law Working Paper No. 11-19
(May 11, 2011)

Abstract

The U.S. Medicare program reimburses only for discrete treatments of
individuals with infections, but fails to pay for infection control or 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 may actually lose money and benefit rival firms in the market. In
effect, current Medicare rules subsidize MRSA pollution. Worse yet, Medicare
rules block potentially efficient Coasian contracts to promote private coordination
within germ sheds.

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Suggested Citation:

Kevin Outterson and Olga Yevtukhova, "Germ Shed Management in the United States," in ANTIBIOTIC POLICIES: CONTROLLING HOSPITAL-ASSOCIATED INFECTION (Ian M. Gould and Jos van der Meer, eds., Springer, 2011).

Kevin Outterson
Boston University School of Law
765 Commonwealth Avenue
Boston, MA 02215

Email address: mko@bu.edu
Office Phone: (617) 353-3135

Olga Yevtukhova

Email address: olga.yevtukhova@gmail.com

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