Archive for Tuesday, February 19, 2008

No-pay idea for hospital errors gains steam

February 19, 2008


— It's a new way to push for patient safety: Don't pay hospitals when they commit certain errors.

Medicare will start hitting hospitals where it hurts in October, and other insurers are hot on the trail.

That has the nation's hospitals exploring innovative programs to prevent injury and infection: Hand-washing spies. Surgical sponges that sound an alarm if left in the body. Even a room sterilizer that promises to wipe out bacteria left lurking on bedrails.

"Money talks," says Dr. Steven Gordon, infectious disease chief at the Cleveland Clinic Foundation. "Every hospital CFO, this gets their attention."

And patients' first sign that something is changing may involve lessening of a big indignity: Today, one in four hospitalized patients is outfitted with a urinary catheter. The tubes trigger more than half a million urinary tract infections a year, the most common hospital-caused infection.

Yet many patients don't even need catheters - they're an automatic precaution after certain surgeries - and many who do have them for days longer than necessary. Why? The University of Michigan reported the first national study of catheter practices last month, finding nearly half of hospitals don't even keep track of who gets one. Fewer than one in 10 hospitals does a daily check to see if the catheter is still needed, a simple but proven infection-reducing system.

With those infections topping Medicare's do-not-pay list, Gordon says hospitals already are beginning to get choosier about who needs catheters, and to yank them faster.

Even when a hospital makes a preventable error, it still can be reimbursed for the extra treatment that patient will now require. Some errors can add $10,000 to $100,000 to the cost of a patient's stay.

Beginning Oct. 1, Medicare no longer will pay those extra-care costs for eight preventable hospital errors, including catheter-caused urinary tract infections, injuries from falls, and leaving objects in the body after surgery. Nor can hospitals bill the injured patient for those extra costs.

Medicare, which insures about 44 million elderly and disabled people, estimates the move will save the government about $190 million over five years. Private insurance giants are following suit, moving to make hospitals absorb the cost of serious errors.


Ragingbear 10 years, 3 months ago

The hospitals may not be allowed to bill you, but they will still get you via collection agency, and then they will just refuse to treat you at all.

akt2 10 years, 3 months ago

A hospital can not refuse a patient treatment in the emergency room based on the ability to pay. They must treat and release, treat and admit, or stabilize and transfer the patient. Hospitals and physicians provide plenty of "charity" care for the truly needy. Our government foots the bill for many more in the form of Kansas Medicaid. Yet still these so called "non profit" hospitals are raking in millions of dollars in profit. They won't even tell you up front what a test or procedure costs. They should be forced to disclose their costs, and let the patient/consumer make an informed decision as to where they have treatment. It's a racket.

Ragingbear 10 years, 3 months ago

~~A hospital can not refuse a patient treatment in the emergency room based on the ability to pay.~~

That only pertains to women giving birth and life threatening conditions. They can turn everyone else away.

akt2 10 years, 3 months ago

That might happen in other parts of the country. Not Lawrence. There are laws that fall under EMTALA. The laws prevent patient dumping and discrimination based on insured versus uninsured. The fines levied to hospitals are huge if the laws or patients rights are violated. EMTALA stands for Emergency Medical Treatment and Active Labor Act. These laws apply to all hospitals that receive Medicare and Medicaid money.

Ragingbear 10 years, 3 months ago

There are all sorts of laws that just because they are on the books, doesn't mean they have to follow them. LMH has broken the rules several times, and have caused at least 1 death that I know of, and possibly hundreds more.

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