Medicare Won't Pay Hospitals For Preventable Errors

The Bush Administration announced on Saturday that Medicare will no longer pay hospitals for injuries and errors traditionally deemed “preventable,” reports the Washington Post. This is good news for consumers as it will force hospitals to introduce efficiences and adhere best practices. These errors are things like bed sores, infections, slip and fall injuries, and the costs of leaving surgical instruments inside patients after surgery. And perhaps most importantly, a provision in the new rules forbids passing on the costs of preventable errors to consumers. The decision will also save the Medicare program millions of dollars.

Medicare No Longer to Pay for Preventable Hospital Errors, Injuries or Infections
[Washington Post]

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  1. iKnow says:

    Isn’t every injury preventable? and I bet you or I or any other taxpayer will see a cent of those millions of dollars saved. Instead the money will get “lost” in the system.

  2. castlecraver says:

    Raise your hand if you actually think these costs won’t get passed on to patients somehow.

  3. Yoni K says:

    So no more insurance payments for iatrogenocide?

  4. GrumpyMD says:

    Well, I guess it’s back to tying every patient down to the bed to prevent them from falling. ’cause even with all 4 rails up, patients manage to fall out of bed.

    And I guess we should also force feed all medications to make sure they’re all taken. Better bring back the snake feeding tube.

    I’ll think of other measures that’ll prevent medical errors in a minute or two.

    Oh yeah, better bill medicare for the new costs associated with these interventions.

    And brace for a new round of lawsuits from the restrained patients.

    Yup, this’ll be a cost saving measure. Good call, medicare! And I bet EVERY insurance company’ll jump on the bandwagon by tomorrow.

  5. alice_bunnie says:

    @Yoni K:

    Someone’s been reading a bit too much Robin Cook. I stopped reading those when I was 15 and thought they were ridiculous.

  6. homerjay says:

    My wife deals directly with this stuff at a hospital and tells me that it won’t make a lick of difference. The costs assosiated with these types of things are so miniscule when compared with all the other ways hospitals lose money that it’s not even on their radar screen.

  7. facted says:

    Working at a hospital on a daily basis, I can tell you that these are some of the most ridiculous laws ever passed. Unfortunately, infections in hospitals happen and to not pay for them it not the answer to curing or preventing them.

    The inefficencies of the medical system are too numerous to count, but if they really wanted to save some money, let’s start by implementing electronic records so that I could look up the CT results of a patient at an outside hospital whenever I wanted, rather than having to have a patient sign a form, call medical records at the other hospital, fax it over, and wait about 2 days to get anything back. (Hint: The CT will get repeated well before that happens, and it costs taxpayers a whole lot of money.)

    Or how about patients who stay in the hospital for days and days extra simply because of social reasons (they can’t go home due to unsafe home conditions, or can’t find shelter placement, or no nursing home is available). Clearly these patients shouldn’t be thrown out on the street, but at $5000 a night, the hospital is a pretty expensive babysitter!!!

  8. bglav says:

    Someone will pay. It might not be Medicare, but it will get pushed evenly to the other patients and insurance companies.

  9. BrockBrockman says:

    I want to believe this is a good thing, but it reminds me too much of the “No Child Left Behind” policy. In theory, it’s good. In practice, a lot of understaffed, underfunded hospitals in poorer communities may just get worse, creating an even bigger gap.

  10. reykjavik says:

    This is easily the dumbest post Consumerist has ever posted. If Medicare had been paying hospitals what they actually required to treat patients this entire time, then they wouldn’t need to make this cut in the first place. Medicare is a scam and most of the money is being embezzled. The last thing we should be doing is trying to save them money.

  11. Hobo-NC says:

    “The Bush Administration announced…”? Ah, Consumerist, you liberal mouthpiece. Why not “Medicare announced” or “HHS announced”?

    Liberals, liberals, liberals. Gotta love ‘em–so predictable.

  12. LTS! says:

    If hospitals could turn away Medicare patients they would and not because of this stupid announcement.

    The entire system has issues, but I can tell you that Medicare is nothing but a drain on taxpayers to begin with. Due to the fixed costs of treating Medicare patients hospitals are forced to then jack the costs of treating other patients to compensate. So, you get to pay higher insurance premiums because someone on Medicare needed treatment.

    There are a million other way the system is completely screwed up, and this is not going to help even the slightest bit. It’s not like we are talking thousands of dollars for procedures that won’t get paid due to “preventable injury” whatever the hell those are. Here’s your bubble sir, enjoy your stay.

  13. VA_White says:

    Right now, hospitals are paid a flat rate based on DRG – diagnosis related group. When a patient gets admitted for a surgery and ends up with a hospital-acquired infection, the hospital gets paid for the surgery AND for the treatment of the infection. There is less incentive to prevent hospital-acquired infections in the current system.

    Medicare is also moving towards pay-for-performance in which hospitals would get paid more the better they follow the established standards of care. Right now they get paid the same whether they kill more patients or not. Shitty hospitals like MLK in LA would get paid less if they let too many of their patients exsanguinate in the waiting room or fail to recognize that a patient is having a stroke.

    Also they plan to make the metrics public and searchable so that when you are trying to decide what hospital should do your mom’s hip replacement, you can look up which ones kill old ladies with post-op staph infections and which ones don’t.

    Good hospitals can’t wait to cash in on their high standards of care. Crappy hospitals are shitting their pants.

  14. m.ravian says:

    @Hobo-NC:
    i think that The Consumerist reported that “Bush administration announced” these changes because, well, the Bush administration announced it. to quote the article:

    “and the Bush administration has decided that Medicare will no longer pay the additional costs for treating them.”

    way to advance the dialogue with useless labels. *rolls eyes*

  15. Buran says:

    @facted: I think this is about things like surgeons operating on the wrong site. Now the hospital can’t just brush it off and expect that they’ll get paid for it.

    I think it’s like expecting a repair shop to pick up the tab if they screw up repairing something of yours that broke. You certainly don’t expect to be charged twice.

  16. Buran says:

    @bglav: I’d rather that everyone pay a dollar more for their care than every single one of the American taxpayers get stiffed with gigantic medical bills. Let only those who are involved with the hospital that screwed up pay.

  17. Buran says:

    @Hobo-NC: So you bash the poster of this article with a label that absolutely makes no sense (and “liberal” is not a smear word anyway) — and you bash them for POSTING AN ACCURATE STORY?

    Would you have complained if the story had inaccurate attribution, too?

    My god, I thought complaining over stuff posted on the Internet was out of hand already, but complaining over an ACCURATE story is ridiculous.

  18. nctrnlboy says:

    Hopsitals will just recoup the costs by increasing the common practice of charging patients for items/services/surgeries they didnt have done. “Oops! It was just a billing error!”

  19. crankymediaguy says:

    @Hobo-NC:

    Shouldn’t you be in Iraq looking for some Weapons of Mass Destruction?

    Your President said they were there, so they MUST be. Go help him find them, Mr. Kool-Aid Drinker.

  20. Jaysyn was banned for: http://consumerist.com/5032912/the-subprime-meltdown-will-be-nothing-compared-to-the-prime-meltdown#c7042646 says:

    @lookatmissohio:

    You don’t really think he actually read the article before he spouted off do you?

  21. bohemian says:

    I didn’t see anything in the article that patients would be protected against being stuck with the bill. That is the big one, if that is not really in there all this will do is cause more patients to lose everything they own to a hospital.

    Hospitals should be required by federal law to post the prices for EVERY service in the medical code list. They should also do the forced publicly posted statistics of infections, deaths, botched surgery etc.

  22. @castlecraver: *hand stays down*

  23. @bohemian: “Hospitals should be required by federal law to post the prices for EVERY service in the medical code list.”

    They’re generally required to do this, and to make available the varying rates they charge insured, Medicare, and uninsured patients, as well as rates that vary by insurance company (since they work independent deals w/ the hospital and bigger ones get better rates).

    I’m not sure if this is state or federal law, tho, and the hospitals can still make it ass-hard to get their hands on this data … not least because it invites racial discrimination lawsuits, since in urban areas with minority poverty problems, it almost always means minorities are disproportionately overcharged because they’re disproportionately uninsured.

    (Not that it’s intended as discriminatory, but if you can show a benign-intent rule or law or whatever is adequately discriminatory in practice, you can at least bring a case, and that kind of publicity is embarrassing no matter what happens with the lawsuit.)

  24. silverlining says:

    @castlecraver: Exactly.

  25. Trai_Dep says:

    @BrockBrockman: Yeah, color me suspicious, but anything coming out from the Republicans saying “we’ll make it better!” ends up making it infinitely, exquisitely, profoundly worse. It’s their gift.

    @Hobo-NC: you aren’t familiar with the Constitution, apparently. The Judicial and Congressional branches don’t “own” agencies like this. The Executive does. So it’s proper to say, “The Bush Administration said…” Commie.

    I’d like to see this principal applied to insurance companies as well: any malfeasance or delays that are their fault come out of their pocket, no binding arbitration, no lawyering to death, triple damages. Considering that – you know – their overhead is 300% higher than Medicaid/Medicare’s.

  26. BarelyFitz says:

    “a provision in the new rules forbids passing on the costs of preventable errors to consumers”

    I’m glad they will be paying for this from their magical money jar instead of passing the costs onto consumers.

    Huh?

    What do you mean “there is no magical money jar”?

  27. Hobo-NC says:

    @trai_dep: It’s lazy journalism to say, “The Bush administration said…”

    I know HHS is under the exec. branch. Who announced it: HHS, or was it GWB in the Rose Garden?

    My point: don’t be lazy. And don’t be a liberal shill just to score some anti-Bush points.

    BTW, just admit you are liberals, folks! Don’t be ashamed of it.

  28. Nemesis_Enforcer says:

    @Hobo-NC: Uhhhh no I am neither a Liberal nor a Conservative..I am a thinking man who actually decides for myself how I feel not blindly marching to some inept money grubbing poltitical group’s tune. I lean for conservative on some issues and liberal for others.

    We would be so much better off with a legitamite 3rd and 4th party that can/might actually do something to help people instead of passing more BS laws that are already there just not enforced, and trying to help out the poor big companies who might not make an extra million or so..

    Please think before you automatically blanket someone who disagrees with you with you political name calling.

  29. Monica Iceland says:

    In what other type of business (and despite what many people think, hospitals are businesses) are customers expected to pay to fix screwups made when goods or services are provided? I don’t understand what makes medical services special. A restaurant gets your order wrong, its replaced at no charge. An auto repair shop messes up your car, they fix it at no cost to you.

    If, as a previous commentor noted, this is not large part of hospital revenue, why would this up set the medical profession? I work for an insurance carrier and I rarely, if ever, see bills for expenses related to medical errors.

    A tempest in a teapot, if you ask me.

  30. Trai_Dep says:

    Well, that’s probably why the article said “administration” and not “Bush”, “Mr 28%” or “The Chimp”.

    So considering that you’re a virile, anti-liberal sort of guy, I guess that means that you’ll stop taking all that Federal welfare that you Southerner guys suck up? Leeching more money from Washington than you contribute? Unlike, say NY or CA? Or you just enjoy being a welfare queen? And, free-market guy that you are, you’ll start fighting TODAY to stop those awful, artificial tobacco subsidies?

    Guess not. Don’t want rank hypocracy and mewling dependence to get in the way of your finger-pointing…

  31. JustIcedCoffee says:

    If Were a hospital and not a Fire truck
    This would be easy, just transfer a patient and their boo boo to another hospital, they get paid for the sponge removal, and they send their mistakes your way. –

  32. Elvisisdead says:

    There are a few nuggets of truth in the comments, but a lot of assumptions from outsiders.

    Essentially, this legislation means that if a medicare patient didn’t come to the hospital with it, then medicare isn’t paying for it. If you develop something as a complication related to what you came in with, that’s covered. Items that result from a lack of quality of care are not. (Getting into DRGs and ICD-9 codes is a bit complex for non-healthcare folks, never mind risk adjustment scores for individual patients). Essentially, it’s asking providers to care for Medicare patients just as well as they care for private carrier insured or self-pay patients.

    There is also legislation that will adjust payments based on patient satisfaction surveys given to Medicare patients. If the patients aren’t satisfied with their quality of care, then the hospital is paid less.

    Public hospitals will never turn away Medicare patients because they are paying patients. We’d rather have Medicare patients than self-pay (not or under-insured) any day. We get full fee schedule for Medicare patients. Might not get anything for self-pay. EMTALA requires that patients are stabilized and then can be transferred if they are in a state of emergency, regardless of payment. To do otherwise is patient dumping, which is illegal.

    VA_White is dead on about good vs. bad hospitals.

    @NCTRNLBOY – That Medicare billing error will most likely result in a fraud case and a Civil Monetary Penalty. If you do it enough times, it gets you a free trip to “Federal Pound Me In The Ass Prison.”

    What this will most likely result in is a renegotiation of current rates over the next several years so that Medicare does end up paying for it through elevated rates across the board. You can almost guarantee that the AHA and the AMA will make that happen.

    I knew working at the US HHS OS for 6 years taught me something. During that time it was very common for the White House to coordinate press conferences with agencies so that the big man could break the news first. Think of it like if the CEO of a company made an announcement, rather than letting the operating division do it. No different.

  33. drjayphd says:

    @Hobo-NC: Aww, it’s so cute when people still think “liberal” is a valid attack. Who set the WABAC Machine to 2002?

  34. CumaeanSibyl says:

    @Hobo-NC: Wait a minute. Notice the tag that says “Actually, This Is Good”? Since when do die-hard liberals use “Bush administration” and “good” in the same sentence?

    Y’all are losing it, I swear.

  35. Trai_Dep says:

    @CumaeanSibyl: Err, isn’t that, “Y’all is…“?

    Yocal is hard!

  36. @trai_dep: Nope it’s “y’all are” as in “you all are”.

  37. Her Grace says:

    Not every injury is preventable. No matter how many preventative measures are taken, for example, some people WILL get bed sores. Or infections from catheters. Let’s take catheters for example:

    The risk of infection increases the longer a catheter is in place. Moving catheters that are required for a longer term so that it’s never in place for more than X days has the potential for a handful of bad consequences. What do you do? Leave it, with the potential for infection, or move it, with the potential for lung collapse? Medicare’s not paying either way, anymore.

    It’s a dumb, dumb law. Like NCLB, this is done in the right spirit by people too dumb to learn anything about the actual problems. Shame on you, Consumerist, for promoting it.