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.
Next year, Medicare will add three more errors to the no-pay list; ventilator-caused pneumonia and drug-resistant staph infections are top candidates.
Medicare, which insures about 44 million elderly and disabled people, estimates the move will save the government about $190 million over five years.
It also sparked a movement: Private insurance giants like Aetna are moving to make hospitals absorb the cost of serious errors. Pennsylvania last month said it would follow Medicare's example and stop Medicaid payments, too. The American Hospital Association is urging members to voluntarily quit billing for treatment of serious errors, and hospitals in a number of
Well, it's about time. There are far too many people suffering and/or dying from iatrogenic illness.
Many years ago, I was in the hospital for a serious procedure. I was in a so-called "sterile" room, which had a special ventilation system, and was washed down thoroughly every day. People had to scrub up and wear a gown, gloves and a mask when in my room.
In spite of that, I developed a staph infection in the catheter in my chest. I always suspected that the infection was caused by one particular nurse, who was a bit of a slob herself. I had to be in the hospital an extra MONTH because of the infection. It actually put my life at risk.
At the time, I considered what had happened just one of those unavoidable things. As I have learned more, I realized that my infection, my long stay in the hospital, and the increased costs to my insurer was preventable.
I expect that what Medicare is doing will eliminate some of these problems. It would be wonderful if other insurance companies follow Aetna's lead!
Hmmm.............I suppose that none of you have been, or have known someone who has been in a position of being made sick or worse by a doctor or a hospital. I would have expected a lot of reaction to this thread.
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DrewDad
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Tue 19 Feb, 2008 11:49 am
I suspect that the cost of the primary procedure will just get bumped a little bit....
Noddy- Good article. Thanks. Funny thing, the catheters were put in me in January. I did not go to the hospital until the middle of March. My husband was taught how to care for the catheter. While he was cleaning it, (he is a VERY precise person) I had no problems at all. It was only when I was in the hospital (it must have been in late April)that I got the infection.
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littlek
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Tue 19 Feb, 2008 06:06 pm
Pho, what if the insurers decided not to pay for the error and then you got less than adequate treatment (post-staph infection) because they were getting less than expected reimbursement?
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roger
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Tue 19 Feb, 2008 06:15 pm
I'm thinking they would go the ounce of prevention, but who knows.
It's really been awesome that doctors and hospitals could charge extra for their own mistakes, hasn't it.
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fishin
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Tue 19 Feb, 2008 06:23 pm
roger wrote:
It's really been awesome that doctors and hospitals could charge extra for their own mistakes, hasn't it.
lol I suspect that this is exactly why there aren't many complaints about all of this.
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Phoenix32890
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Wed 20 Feb, 2008 05:57 am
littlek wrote:
Pho, what if the insurers decided not to pay for the error and then you got less than adequate treatment (post-staph infection) because they were getting less than expected reimbursement?
I may be a Pollyanna, but I think that if hospitals were on notice that they were being held responsible for avoidable mistakes, they would put policies into place that would prevent these errors. Then again, there would always be the concern about law suits.
For instance, if you looked at Noddy's link, it just takes a bit of training and oversight to prevent many of the medical errors that occur quite routinely now, like staph infections.
Some years ago, there was a huge scandal about a man who had the wrong leg amputated. Not too long afterwards, I was having an operation on my hand, I was given a permanent magic marker, and told to mark the hand that was to be worked on. I drew an arrow that could be seen at 100 yards away!
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squinney
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Wed 20 Feb, 2008 06:33 am
DrewDad wrote:
I suspect that the cost of the primary procedure will just get bumped a little bit....
That's what I suspect will happen. Medicare still has limits on what it will pay for a given procedure, but that doesn't mean bills can't be padded for non-medicare patients.
Hopefully it will set their intention on prevention. Would love to see some stats on the items already on the list for the year before and after it went into effect.
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Noddy24
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Wed 20 Feb, 2008 02:22 pm
Many medical practitioners get lyrical about the "Art of Medicine" . All the same routine check lists--like the one for installing a catheter--have been proven to be very effective in reducing all sorts of post-op complications.
"Accidents" don't have to happen.
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littlek
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Wed 20 Feb, 2008 06:45 pm
Brighams and Womens has reduced the introduced infection rate to almost zero by following some very simple and very easy steps before ER patients are seen. Simple as in, wash your hands. And the hospital gave the nurses the ability to call the Doc out on any missteps they take. Little or no cost, high success.
Mistakes really shouldn't happen.
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Noddy24
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Thu 21 Feb, 2008 02:17 pm
Last year a neighbor had emergency gall bladder surgery. He's quite overweight--obese--and the Anesthesiologist was having trouble keeping him sedated.
Evidently the closing was done in a hurry and a section of bowel was twisted and crimped in the process. After much pain and suffering, second and then a third operation proved necessary.
The hospital billed the neighbor for new deductables. The neighbor called the private insurance company and was told--"Don't pay them anything. We're not going to pay for their mistakes, either."
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Miller
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Thu 21 Feb, 2008 02:22 pm
Medicare is also charging patients for missed doctor visits.
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Miller
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Thu 21 Feb, 2008 02:24 pm
Noddy24 wrote:
"Accidents" don't have to happen.
As long as humans ae involved, there will be mistakes.
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