Medicare and Medicaid increasing incentives to reduce "never events"

The Centers for Medicare & Medicaid Services (CMS) announced on July 31, 2008 that it is taking several additional actions to improve the quality of care in hospitals and reduce the number of "never events" -- preventable medical errors that result in serious consequences for the patient.

For the Medicare program, CMS has provided additional incentives for hospitals to improve the quality of care provided to people with Medicare, including payment provisions to reduce never events that occur in hospitals.  In addition, CMS sent a letter to state Medicaid directors providing information about how states can adopt the same never events practices. Almost 20 states either have already eliminated or are considering eliminating payment for some never events.

Last year, CMS listed eight preventable conditions for which it would not make additional payments.  This year it is adding three:

• Surgical site infections following certain elective procedures, including certain orthopedic surgeries and bariatric surgery for obesity
• Certain manifestations of poor control of blood sugar levels
• Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures

Many private insurance companies have now implemented similar policies as covered by Patient Safety Focus earlier.