First, do no harm. That's the guiding principle of medicine. But we all know that another cliche also applies: To err is human.

Nevertheless, the federal government will no longer forgive--or pay-- for additional patient care as a result of selected preventable hospital errors or "never events." These include falls/trauma, surgical instruments left in patients, administering the wrong blood type, deep vein thrombosis, hospital-acquired urinary tract infection, and others.

The long-anticipated reimbursement changes affect patients discharged as of Federal FY 2009 (which began Oct. 1, 2008). Private insurers often follow the lead of the Centers for Medicare and Medicaid Services in their reimbursement decisions and some state programs are also following suit. The additional costs of treatment that result from hospital induced or acquired episodes won't be covered and the costs cannot be passed on to patients, families or their insurers.
While the anticipated savings to CMS are relatively small, estimated in the tens of millions in a budget of more than $100 billion, the measure toward quality of care is considered a significant shift in focus. From the patient perspective, quality improvement efforts to prevent the errors may greatly reduce pain, suffering, and needless death.

"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."

The most important cliche of all may be that an ounce of prevention is worth a pound of cure. However, in a field also subject to the laws of nature, some healthcare providers have noted that not all "never events" on the government no-pay list are entirely preventable, including many infections.

Additional resources:

For an explanation of the rule and links, go to CMS.

To read the final rule, go to: The Federal Register.

Read DOTmed's prior coverage of the topic go here.

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