No Pay For Harm

[Zach]

Maybe it's time to include hemodialysis centers in this policy.



http://www.nytimes.com/2008/10/05/opinion/05sun3.html?ref=opinion

October 5, 2008
The New York Times
EDITORIAL
No Pay for Harm

It is good to know that hospitals will no longer profit from their mistakes under a new payment policy just inaugurated by Medicare. Too bad the same will not be true of doctors, at least not yet.

Starting this month, Medicare will no longer pay hospitals for the added cost of treating patients who acquire any of 10 “reasonably preventable” conditions while hospitalized. Those include incompatible blood transfusions, severe bedsores, injuries from falls, poor blood sugar control, and infections after certain surgeries. The institution cannot bill the patient for these either. It must absorb the cost of repairing the damage it caused.

This is a small but hugely important step in the direction of paying hospitals based on the quality of care they deliver. It will not save much money at first — only about $21 million a year. In the long run, as the list of conditions is expanded and more insurers follow Medicare’s lead, the savings could be substantial.

The most important benefit will come if the new rules persuade hospitals to work harder to prevent errors and protect their patients.

The policy focuses exclusively on hospitals, as directed by Congress, and lets doctors off scot-free. If surgeons leave a sponge or an instrument in a patient and have to operate again to retrieve it, the hospital will not be paid for the second operation, but the surgeons will.

A new Medicare proposal would begin to address that inequity by denying payment to surgeons who operate on the wrong body part or the wrong patient. In theory, Medicare is not supposed to pay for such mistakes right now, as they are never reasonable and medically necessary. But Medicare is wisely seeking a national policy to ensure uniform payment decisions. That is a small but welcome step toward stopping doctors, not just hospitals, from making money off their errors.

[Mimi]

Hooray!!!  It is about time.  Maybe some of the fatal mistakes by hospitals will begin to disappear.

[pelagia]

definitely sounds like a step in the right direction 

[Wallyz]

I disagree.  What I predict will start happening is that people will be sent home with serious infections, and then will be re-admitted with the hospital taking no liability.  Patients will die because they will not be treated.

I hope I am wrong, but I have seen too many horrible medical decisions made based on whether or not the hospital/provider will get paid.

[Zach]

I disagree.  What I predict will start happening is that people will be sent home with serious infections, and then will be re-admitted with the hospital taking no liability.  Patients will die because they will not be treated.

You may be right.  DRGs have caused something similar to occur already.

[Wallyz]

Exactly what I was thinking about.

[pelagia]

okay, I can definitely see the point you are making.  but then how do they get better accountability into the system?  can't the regs be written so that they can't send someone home with with a serious infection that is contracted in the hospital?

[flip]

That's where the lawyers come in.

[Rerun]

Doctors already deny treatment to Medicare Patients.  Hospitals will now do the same.  NO one wants to take any responsibility for wrong doing.  The hospitals should not get anything for mistakes in the first place.  Let alone create mistakes for profit which probably happens.  Bastards!

                                                   

[Zach]

Doctors already deny treatment to Medicare Patients.  Hospitals will now do the same.

What will probably happen is that private insurance will follow Medicare's lead.

[flip]

again......that's where lawyers come in

[Wallyz]

Yay! my Kids will win a settlement after the Hospital kills me!

[jbeany]

Yay! my Kids will win a settlement after the Hospital kills me!

There's that positive attitude they keep telling us is so important!