Medicare Won't Pay Hospitals for Errors

[Guest guest]

This was in our Baltimore paper and thought I'd pass it on to everyone. Some

thing certainly needs to be done about errors and how about all the

infections in hospitals. I have often thought about stethoscopes & how they

travel

from room to room then patient to patient!!! Hospitals are supposed to be clean

places but they're not. Just take a good look around next time you visit one!

Sue

_http://www.examiner.com/a-1229637~Medicare_Won_t_Pay_Hospitals_for_Errors.htm

l_

(http://www.examiner.com/a-1229637~Medicare_Won_t_Pay_Hospitals_for_Errors.html)

Health

Medicare Won't Pay Hospitals for Errors

By LAURAN NEERGAARD, The Associated Press

2008-02-19 22:20:04.0

Current rank: # 711 of 8,835

WASHINGTON -

It's a new way to push for patient safety: Don't pay hospitals when they

commit certain errors. _Medicare_

(http://www.examiner.com/Subject-Medicare.html)

will start hitting hospitals where it hurts in October, and other insurers

are hot on the trail.

That has the nation's hospitals exploring innovative programs to prevent

injury and infection: Hand-washing spies. Surgical sponges that sound an alarm

if left in the body. Even a room sterilizer that promises to wipe out bacteria

left lurking on bedrails.

" Money talks, " says _Dr. Gordon_

(http://www.examiner.com/Subject-_Gordon.html) , infectious disease chief

at the _Cleveland Clinic

Foundation_ (http://www.examiner.com/Subject-The_Cleveland_Clinic.html) . " Every

hospital CFO, this gets their attention. "

And patients' first sign that something is changing may involve lessening of

a big indignity: Today, one in four hospitalized patients is outfitted with

a urinary catheter. The tubes trigger more than half a million urinary tract

infections a year, the most common hospital-caused infection.

Yet many patients don't even need catheters - they're an automatic

precaution after certain surgeries - and many who do have them for days longer

than

necessary. Why? The _University of Michigan_

(http://www.examiner.com/Subject-University_of_Michigan.html) reported the

first national study of catheter

practices last month, finding nearly half of hospitals don't even keep track of

who gets one. Fewer than one in 10 hospitals does a daily check to see if the

catheter is still needed, a simple but proven infection-reducing system.

With those infections topping Medicare's do-not-pay list, Gordon says

hospitals already are beginning to get choosier about who needs catheters, and

to

yank them faster.

Even when a hospital makes a preventable error, it still can be reimbursed

for the extra treatment that patient will now require. Some errors can add

$10,000 to $100,000 to the cost of a patient's stay.

Beginning Oct. 1, Medicare no longer will pay those extra-care costs for

eight preventable hospital errors, including catheter-caused urinary tract

infections, injuries from falls, and leaving objects in the body after surgery.

Nor can hospitals bill the injured patient for those extra costs.

Next year, Medicare will add three more errors to the no-pay list;

ventilator-caused pneumonia and drug-resistant staph infections are top

candidates.

Medicare, which insures about 44 million elderly and disabled people,

estimates the move will save the government about $190 million over five years.

It also sparked a movement: Private insurance giants like _Aetna_

(http://www.examiner.com/Subject-Aetna_Inc..html) are moving to make hospitals

absorb

the cost of serious errors. _Pennsylvania_

(http://www.examiner.com/Subject-Pennsylvania.html) last month said it would

follow Medicare's example and stop

_Medicaid_ (http://www.examiner.com/Subject-Medicaid.html) payments, too. The

_American Hospital Association_

(http://www.examiner.com/Subject-American_Hospital_Association.html) is urging

members to voluntarily quit billing for

treatment of serious errors, and hospitals in a number of states, from

_Minnesota_ (http://www.examiner.com/Subject-Minnesota.html) to _Vermont_

(http://www.examiner.com/Subject-Vermont.html) , have announced they will.

Many hospitals already were trying to improve patient safety for a bigger

reason - to prevent suffering and death - and a question is whether making them

literally pay for mistakes will spur greater improvements. But some novel

attempts are under way:

-A standard mop-and-bucket cleaning leaves bacteria in hospital rooms,

especially on electronic equipment that janitors hesitate to touch. So the

Wellmont Health System in _Kingsport_

(http://www.examiner.com/Subject-Kingsport.html) , _Tenn._

(http://www.examiner.com/Subject-Tennessee.html) , is testing a

portable machine that sterilizes a closed room by spewing out vaporized

hydrogen peroxide that reach into every nook and cranny.

_STERIS Corp._ (http://www.examiner.com/Subject-STERIS_Corporation.html) 's

VaproSure is proven to eliminate tough germs; it has long been used in sterile

manufacturing facilities, and even helped clean buildings tainted in the

2001 anthrax attacks.

But doctors, nurses and others bring new germs into rooms every time they

enter, raising the question of whether sterilizing between check-ins will

really lead to fewer infections.

" There's no question they can sterilize a room, " Wellmont chief executive

_Dr. Salluzzo_ (http://www.examiner.com/Subject-_Salluzzo.html)

says of the $180,000 machines. " Has it prevented infection? We don't have the

answer to that yet. "

He hopes to have enough data to tell by year's end.

-Nurses count surgical sponges to make sure they're all out before a patient

is sewn up, but every hospital occasionally misses some. In University of

Michigan operating rooms, doctors are testing sponges tagged with bar code-like

radiofrequency chips. Wave a wand and a beep sounds if a sponge is still in

the wound. Or, nurses can drop used sponges into a " smart " bucket that counts

how many are missing.

" We've had a long history in medicine of this problem continuing to occur no

matter what kind of very careful steps we've devised, " says clinical affairs

chief _Dr. Darrell _

(http://www.examiner.com/Subject-Darrell_.html) , a well-known patient

safety specialist. " We want to get to zero. "

-In U-Michigan's hospital halls, physician assistants are assigned to spy to

tell if fellow workers wash hands both when entering and exiting patient room

s. Workers are better at remembering on the way in, but they don't want to

carry germs back to the nurses' station or elevator buttons, either,

notes. Some bugs can live on cool hospital surfaces for weeks.

There is some concern that the no-pay push could make hospitals try to hide

certain errors, or just trade one problem for another. Pull a urinary

catheter too soon, for example, and a fragile patient may fall going to the

bathroom, says _Michigan_ (http://www.examiner.com/Subject-Michigan.html) 's

.

" I don't know how much is really preventable, " adds the Cleveland Clinic's

Gordon. " We want to chase zero, but we'll probably never get to zero. "

---

_n Neergaard_ (http://www.examiner.com/Subject-n_Neergaard.html)

covers health and medical issues for _The Associated Press_

(http://www.examiner.com/Subject-The_Associated_Press.html) in _Washington_

(http://www.examiner.com/Subject-Washington.html) .

Copyright 2007 The Associated Press. All rights reserved. This material may

not be published, broadcast, rewritten or redistributed.

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2050827?NCID=aolcmp00300000002598)

[Guest guest]

It's all SO unfair. Patients should not be responsible for a hospitals

mistake. I dread ever having to spend any time in one. As a patient we should

demand gowns, gloves, masks, etc. for anyone who walks into the room, including

family! May be that would help some.

Patients have to sign a paper saying that they are the payer of full

responsibility. If Medicare and the hospital

get into an argument, just like with insurers, then I think (please correct

me if I'm wrong)

it may fall on the patient to pay the full amount while they duke it out.

If someone is already sick from a hospital mistake, they are in no position

to pay that too.

**************Ideas to please picky eaters. Watch video on AOL Living.

(http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campos-duffy/

2050827?NCID=aolcmp00300000002598)

[Guest guest]

Patients have to sign a paper saying that they are the payer of full

responsibility. If Medicare and the hospital

get into an argument, just like with insurers, then I think (please correct

me if I'm wrong)

it may fall on the patient to pay the full amount while they duke it out.

If someone is already sick from a hospital mistake, they are in no position

to pay that too.

[Guest guest]

I wonder how much those (disposable, paper) masks and gowns would cost you?

Or the " disposable mucus removal systems " you might unwittingly use?

(tissues)

I know it defeats the purpose there to bring your own, though.. theirs are

probably cleaner.. at least you would hope.

But... you are right. I have heard that everybody should keep a log of every

thing that happens to them in the hospital, everything that happens in every

nurses visit, every single thing you use, every thing you say.

I think many of us are living beyond our means. With the costs of so many

things going up so much and incomes going down, we need to be much more

self-sufficient, somehow. Every interaction you have with these people costs

you money.

They want SO much that honestly, we need to stop spending money on almost

everything.

Its the only way we are going

to be able to survive when bad things happen.

On 2/21/08, ssr3351@... <ssr3351@...> wrote:

>

>

> It's all SO unfair. Patients should not be responsible for a hospitals

> mistake. I dread ever having to spend any time in one. As a patient we

> should

> demand gowns, gloves, masks, etc. for anyone who walks into the room,

> including

> family! May be that would help some.

>

> Patients have to sign a paper saying that they are the payer of full

> responsibility. If Medicare and the hospital

> get into an argument, just like with insurers, then I think (please

> correct

> me if I'm wrong)

> it may fall on the patient to pay the full amount while they duke it out.

>

> If someone is already sick from a hospital mistake, they are in no

> position

> to pay that too.

>

>