Medicare to Slash Payments for Medical Errors
The Medicare system has long been under fire for its failure to enforce better quality in the hospitals it reimburses for care. Now federal officials have launched two new programs aimed at addressing this problem, The Post's Gilbert M. Gaul reports.
Starting today, Medicare will slash hospital payments for medical mistakes resulting in patient harm and higher costs to the sprawling federal health plan for the elderly and disabled. Examples of such mistakes include transfusing patients with the wrong blood type and leaving a sponge in a patient during surgery.
And in another development, federal officials late last week approved a new company to begin inspections as part of its often criticized hospital accreditation program. DNV Heathcare becomes the first new accreditor in more than three decades, according to the Houston-based company. Until now, the Joint Commission on the Accreditation of Healthcare Organizations has effectively held a monoply on the hospital reviews, which are required in order to participate in Medicare.
Both moves come as Medicare and growing numbers of private insurers are increasing their focus on patient safety and quality following disclosures of negligent care by advocacy groups, congressional investigators and media outlets.
In July of 2005, Gaul revealed widespread shortcomings in Medicare's quality and oversight programs in a three-part series, Chronic Condition. Among the findings: that the Joint Commission had collected hundreds of millions in fees from its accreditation program while rarely flunking hospitals for poor care and missing glaring cases in which patients were injured or killed. The stories also detailed how hospitals could get higher Medicare payments for mistakes and bad care requiring frequent surgeries and readmissions.
The Deficit Reduction Act of 2005 requires Medicare-participating hospitals to begin reporting a series of clearly preventable medical errors ranging from pressure sores to catheter infections to fractures caused by hospital workers, among other conditions. It has been estimated that Medicare pays for more than half of all hospital-acquired infections.
The Centers for Medicare & Medicaid Services will no longer pay the hospitals an increased rate for the added care resulting from their errors. Medicare will also prohibit billing the additional costs to patients, according to the Center for Medicare Advocacy, a nonprofit group that tracks Medicare developments and advocates for patients.
DNV Healthcare, meanwhile, said it will immediately beging competing with the Joint Commission for hospital accreditations. "We're ready to go," DNV's President, Yehuda Dror said in an interview. "The significance is that for the first time in 40 years a new program has been deemed [approved] by Medicare and hospitals will have a choice." Dror added, "Our role is to be a leader in hospital accreditation, not just to offer another option."
By The Editors |
October 1, 2008; 7:07 AM ET
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