A change in Medicare policy to no longer pay for hospital infections and medical errors has one Kansas health consumer group worried that the costs will be passed on to patients.
Corrie Edwards, executive director of the Kansas Health Care Consumer Coalition, questions who will eventually end up paying when hospitals pick up the tab for infections or errors that occur on their grounds.
"The reality is someone is going to have to pay for this, whether it is a write-off for the hospital or passed on to people who have insurance," Edwards said.
Although officials at Lawrence Memorial Hospital and Kansas University Hospital have concerns with the new policy, they say it shouldn't have much of an effect on their bottom lines.
"In terms of the general thrust of the being accountable for the quality of care you receive, that is something we feel we've already adopted," KU Hospital spokesman Dennis McCulloch said. "And because of that, we certainly don't fear a rule change or anything like that that will impact reimbursement."
Traditionally, McCulloch said, uncompensated care does get passed on to consumers. He points to malpractice lawsuits.
"That's why we say it's good business for hospitals to invest in the quality of care," McCulloch said.
The Centers for Medicare & Medicaid Services this month released new rules that will stop payment to hospitals for what it called "preventable conditions." Those conditions include falls, bedsores and infections that can occur at hospitals. The changes also cover medical errors made during surgery, such as objects left in the body, infusing someone with the wrong blood type and air embolism.
The changes will take effect in October 2008.
The regulations are among a list of reforms Medicare is making to its payment system to hospitals. Along with reducing costs, the changes also are aimed at improving hospital care.
According to the Centers for Disease Control and Prevention, there are 1.7 million health-care related infections each year, and nearly 100,000 people die from them. The cost to treat them can reach $27.5 billion.
"We think it is a good thing for Medicare to use its clout to try to put pressure on hospitals to do a better job of preventing infections," Consumers Union spokesman Michael McCauley said.
At LMH, Vice President of Clinical Services Karen Shumate said some of the conditions on the list - such as using the wrong blood type - are a rare occurrence. And, many times when the hospital is in the wrong, Shumate said, the hospital picks up the tab.
"We don't charge now if we feel like we caused or contributed to a condition," she said.
The biggest result of the rules, Shumate said, will be that hospitals need to make sure they document all of the patient's conditions before admission. And more lab tests might be required for incoming patients.
Because hospital stays can be short, Shumate said, it can be hard to figure out where infections originated once a patient leaves.
McCulloch has similar worries, noting that KU Hospital accepts patients from other hospitals and could have difficulty tracking down just where an infection was acquired.
And Shumate said some of the conditions, such as bedsores, could occur to highly prone patients regardless of the precautions taken by the hospitals.
McCulloch points to KU Hospital's burn center - the only one in the region - and said its patients are much more vulnerable to infections.
"We will put our infection rate against anyone in the country, but nobody is at zero just because of the type of business you are in and the unpredictability," McCulloch said.