CMS to Stop Paying for Preventable Hospital Errors and Events

CMS to Stop Paying for Preventable Hospital Errors and Events

by Barbara Kram, Editor | May 29, 2008
Medical errors are making headlines again. Actor Dennis Quaid's newborn twins were mistakenly administered adult doses of a blood thinner at an L.A. hospital last year. The labeling of the product has been partly blamed.

In other recent medical mix-ups, doctors in Providence, RI operated on the wrong side of patients' heads in three different cases last year. At a veterans' hospital, surgeons implanted an unsterilized cranial plate in a patient, leading to complications. In yet another case, a dialysis patient was injected with cleaning fluid meant for the machine, instead of the pharmaceutical agent used in the dialysis process.

Although these particular incidents aren't the focus, the government has new regulations aimed at preventing hospital errors. Beginning in October, Medicare will no longer pay the cost of several medical preventable errors or "never events" that occur in hospitals. These include transfusing patients with the wrong blood type, injuries from falls, bedsores, objects left inside a patient during surgery, urinary tract infections from catheters, and others.

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The proposed rule would apply to services provided to patients who are discharged from acute care hospitals during the federal fiscal year 2009, which begins October 1, 2008.

"CMS is taking aggressive actions to ensure that beneficiaries get safe, high quality, and efficient care from their health care providers," said CMS Acting Administrator Kerry Weems. "Medicare can and should take the lead in encouraging hospitals to improve the safety and quality of care and make better practices a routine part of the care they provide not just to people with Medicare, but to every patient they treat."

CMS has been working with the National Quality Forum (NQF), a national organization working to promote patient safety and improve hospital care, on ways to reduce or eliminate "never events" identified by NQF. In addition, CMS is adding 43 new quality measures (to the current 30) for which hospitals will have to report data in order to receive the full annual payment update for their services.

The Cost of Mistakes and What's Being Done

In its 1999 report, To Err is Human: Building a Safer Health System, the Institute of Medicine (IOM) concluded that medical errors, particularly hospital-acquired conditions (HACs), may be responsible for as many as 98,000 deaths annually, at costs of up to $29 billion. In 2000, the Centers for Disease Control and Prevention (CDC), estimated that hospital-acquired infections added nearly $5 billion to hospital costs. What's more, a 2007 survey by the Leapfrog Group of more than 1,200 hospitals found that 87 percent did not follow recommendations to prevent many of the most common hospital-acquired conditions.