Hospital Mistakes Getting Costlier

An interesting article from April 14th cites the growing costs of preventable medical errors and the aggressive steps that public (Medicare and Medicaid) and private insurers are taking to decrease hospital reimbursements as an incentive for increasing safety.

According to The Hartford Courant:

"When hospitals botch the quality of patient care, their bottom lines often take a hit as their reputations nosedive, regulatory oversight increases, fines are imposed and lawsuits are filed. Now, making a mistake is getting even costlier as health care insurers and the federal government are penalizing hospitals by axing reimbursements for faulty patient care.

In Connecticut, hospitals are required to report preventable medical errors — termed “adverse events” — to the Department of Public Health and face subsequent investigations and potential fines and mandated procedural changes.

From July 2004 to September 2007, 11 percent of adverse events resulted in death. That means 73 people died because of supposedly “preventable” mistakes.

The Centers for Medicare and Medicaid Services (CMS) got the adverse event movement going among insurers: beginning in October, it will no longer pay to treat nine preventable conditions acquired in a hospital, including falls, certain infections and surgery performed on the wrong patient. According to CMS, hospitals must now absorb the cost of treating the condition and may not bill the patient.

The point, CMS said, is that implementing such a provision will give hospitals a financial incentive to take steps to prevent conditions that should never occur in a hospital. Plus, CMS estimates that the move will save Medicare $20 million in FY 2009."

As we've covered in recent months, insurance companies' Aetna and Wellpoint have established "no-pay" policies for preventable medical errors. And, as recently as this month, Anthem has followed suit. There's no doubt that patient safety is increasingly moving into the public discourse.

Moreover, with Medicare/Medicaid and private insurance companies establishing no-pay policies, and patient safety groups like Health Grades publishing reports that cite $8+billion in costs from preventable medical errors, the heat is on hospitals more than ever before to adopt better practices and protocols.

But amid these problems there are proven solutions. And these solutions--focused wholly on prevention--can be implemented immediately.

IHI has created outstanding protocols, Leapfrog is pushing for more transparency and accountability and we have created 24/7, non-intrusive monitoring systems. Efforts and services such as these increase the level of care and decrease preventable medical errors--and in turn, the exhaustive dollars spent on them.

Full article here.