Medicare will start fining hospitals with the worst rates of avoidable infection and avoidable injuries.

About 750 hospitals will be fined a total of $330 million over a year. In the first year of the new fine system, Medicare will look at three indicators: 1) frequency of bloodstream infections among patients who had catheters inserted into a vein to deliver antibiotics, nutrients, chemotherapy or other treatments; 2) the rate of infections from catheters inserted into the bladder to drain urine; and 3) avoidable health problems like bedsores, hip fractures, blood clots and accidental lung punctures.

Over the next few years, Medicare will also factor in infections of surgical wounds and the rates of infection by C. diff and MRSA.

According to Medicare, fines were assigned to more than a third of the hospitals in Alaska, Colorado, Connecticut, the District of Columbia, Nevada, Oregon, Utah, Wisconsin and Wyoming. 54 percent of the nation’s major resident teaching hospitals were also fined.