Health Insurers to Stop Paying for Medical Errors
Posted by
Dan FrithJanuary 18, 2008 6:48 AMMedicare announced last summer that it would no longer pay for the extra cost of treating bedsores (decubitus ulcers), falls and six other preventable injuries and infections that occur when a patient is in the hospital. These changes start in October of this year. Next year Medicare will extend its "no pay" program to hospital acquired infections (think MRSA), blood clots in legs and lungs, and pneumonia contracted from a ventilator.
These events should not occur if the patient is receiving good medical care! Now the private insurers are getting into the mix....
Aetna, the country's third-largest insurer, is starting to require in all new hospital contracts up for renewal that it will no longer pay for, or let patients be billed for, 28 different "Never Events." Never Events is a list compiled by the National Quality Forum (a coalition of doctors, employers, and policy makers) reflecting medical mistakes and errors which should never occur. The list includes leaving an instrument in a patient after surgery, the death of a mother in a low risk pregnancy, allowing a patient to develop bedsores, etc.
WellPoint, Inc., the largest medical insurer in the U.S., is testing a similar no pay program in Virginia. UnitedHealth Group, Inc., and Cigna Corp. are reportedly considering the adopting the same policy.
This change in refusing to pay for hospital medial errors will have one of two results: one positive and one negative. On the positive side, hospitals will work to reduce its errors realizing that it doesn't get paid if it screws up! On the negative side, hospitals will pay only "lip service" to reducing medical errors for which it is not paid and increase its already ridiculously high charges for other patients to make up for the loss of income.
Only time will tell which way the hospitals will chose.
For more information on this subject, please refer to the section on Medical Malpractice and Negligent Care.