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Corrective measure

The Feds have upped the ante on patient care. For hospitals, Medicare policy is added incentive to reduce medical errors

Soft touch no more. Beginning in October next year, the federal government will adopt a zero-tolerance approach to sloppy care in hospitals. Medicare will no longer reimburse hospitals for treating infections, injuries and other medical problems patients acquire while under hospital care.

It's about time taxpayers stopped footing the extra bills for errors that are preventable with reasonable precautions and modifications in care practices.

The issue of patient safety and the prevalence of medical errors has gained wide public attention in the past decade. In 1999, an Institute of Medicine report estimated that a shocking 44,000 to 98,000 patients a year die as a result of mistakes made in hospitals. More recently, the Centers for Disease Control and Prevention has estimated about 1.7 million infections occur in hospitals every year, leading directly or indirectly to some 99,000 deaths. The rising rate of infections such as Clostridium difficile (c. diff) in hospitals and nursing homes is much discussed.

Besides lost lives and lost productivity, treating the complications that result from errors is a huge extra expense. The parties that foot the bills families, the government, insurance companies and employers pay for the initial illness and the mistakes.

The concern to reduce hospital risks and improve the quality of care is driving the effort for greater transparency in reporting medical mistakes. Crucial, too, is the increasing collaboration among hospital administrators, business and insurance groups and and government officials to identify best practices in health care delivery. These range from practices as simple (and cheap) as frequent handwashing by medical staff and better handwriting to the use of state-of-the-art technologies, including electronic medical records, that reduce the potential for errors.

Under the new policy, Medicare will refuse payments for illnesses or conditions that could have been prevented. For example, the government will not pay for a procedure to retrieve a surgical instrument left inside a patient or for a blood transfusion to correct a previous, botched transfusion. Treatments for bed sores, medication errors, falls and hospital-acquired complications such as infections of surgical wounds and catheter sites will not be reimbursed.

Not only will Medicare not pay for a hospital's mistakes, but the providers are barred from passing on the cost to patients. Estimates are the new policy will save Medicare at least $20 million a year. Critics note the policy could raise other costs, for instance, encouraging providers to order more laboratory tests in an effort to identify conditions prior to admission.

Still, the tougher federal stance should serve as a powerful financial incentive for hospitals to pick up the pace, reducing their error rates for greater patient safety.

Soft touch no more. Beginning in October next year, the federal government will adopt a zero-tolerance approach to sloppy care in hospitals. Medicare will no longer reimburse hospitals for treating infections, injuries and other medical problems patients acquire while under hospital care.

Get the full article here.


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