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By 2008, Medicare won't pay for hospital errors
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Now that there could be financial consequences for bed sores, hospitals will need to document carefully the presence of any such wounds (or sores) on admission and discharge. I do not know how nursing homes will be effected by this new payment policy, but it will be in their interest to document the presence of wounds on admission and discharge as well. Wounds and bed sores are a significant area of liability and the oversight will only become more stringent with this new policy in place.
Mark Singh MD www.clinicore.com
As a frequent user of the Fierce website (working for a recoupment contractor for Medicare), I am surprised sometimes by the lack of grammar and spelling in postings by those with advanced degrees in their field. It is "affected", not "effected".
The documentation on admission is going to be required by the MDs as well as nursing. Education of Doctors is a must. In my experience many doctors never document anything about the pressure ulcers patients have. Even at Stage III and Stage IV.
This should have been done a long time ago and maybe Medicare would not be in the shape that it is in now. Hospitals should be held financially liable for the mistakes they/their employees make and maybe the care would improve. Also maybe Medicare should look at other areas of coverage such as the ruling that hospitals are exempt from the Medicare outpatient caps for therapy and they charge so much more for the same treatment.
Cathy, thank you for your thoughts. I personally have no doubt that these payment changes will change hospitals' behavior. The thing is, if the hospital doesn't get paid, won't some eventually try to find ways to get the patient to cover the difference? It's possible we'll end up not lowering the expense, but rather shifting at least some of it to those with less resources. I hope I'm wrong about this, though!
-Anne Zieger, Editor
It seems at outset to be a good idea. Yet like HIPPA it may be more of a burden than a good.
I agree if a surgeon or a surgery team leaves a needle driver or a towel clamp in an patients abdomen the patient nor the healthplan should be responsible. What about the patient who has sequential compression stocking getting subQ lovenox after hip replacement surgery but still develops a DVT or worse a PE. There is NO negligence or substandard care in a case such as this.
In addition saving a poultry $50 million when our medicare budgets in the billions. Where is the bang for the buck? How much will it cost to monitor all of these cases? $60 million a year? No offence but this is typical bureaucratic well intentioned but poorly thought out planning. Seeing as more than half of our healthcare dollars are spent during the last 3 months of patient's lives, don't we have bigger fish to fry?
Amen. Medicare, BCBS, and others have already forced many "for profit" hosptials out of business because of cuts made throughout the years. I know the healthcare industry was out of control with charges and billing practices but who are we hurting when we take actions to correct this to the other extreme? We lose hospitals, patients suffer. What if hospitals chose to not accept Medicare or BCBS patients because of their unrealistic assumption that healthcare providers should be perfect and never commit an error? People do fall in hospitals - despite the best intention - hospitals cannot place one-on-one care with patients. Some people fall regardless of the fact they are alert and oriented with no history of falls. Is that the hosptial's fault or the staff's fault?
I agree some events are "never" events. For instance, your example of the needle left in the patient. But come on folks, get real!!
I guess the next step will be for my car insurance not to cover my medical bills if the accident is my fault?? Because, after all, I am a human being who makes human errors.
As a healthcare provider, I am appauled that insurance companies make the assumption that I am lazy or careless when a patient falls. Sometimes things happen that are out of our control.
So, keep cutting reimbursement to the point that more hospitals are forced to cut staffing, quality of food and supplies, and possibly shut their doors. If you are forced to send your mother 1 hour away while she is having her heart attack and she dies in the back of the ambulance enroute because the hospital around the corner shut down, I am really sorry that happened to your mother or anyone else's mother.






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