Providers are certainly mortified when they make a "never" mistake--such as performing surgery on the wrong limb--but even then, few spontaneously offer to waive the costs of the procedure. These days, however, some large employers are arguing that providers should do just that. The Leapfrog Group, which represents giant employers like Boeing and General Electric, is now asking providers to cancel the bill and issue an apology whenever any of the 28 adverse events takes place. Leapfrog's initiative is supported by The Midwest Business Group on Health, which represents about 80 Chicago-area employers. The events targeted by Leapfrog range from the extreme--such as mixing up donors for an artificial insemination--to more-common problems such as injuring a patient with contaminated tools or drugs.
Observers predict that most hospitals will agree to this proposal, but will still end up working out many problems on an individual basis. In the future, meanwhile, they may come under pressure from insurers as well, as health plans are gradually beginning to rule out payment for never events. One health plan, Minneapolis based HealthPartners, not only requires its network hospitals to report errors to state governments but also won't let hospitals bill patients for these procedures. Eventually, as this trend evolves, hospitals and clinicians may end up eating the fee when more-minor errors occur.
For more background on the issue:
- read this article from the Chicago Tribune (reg. req.)
- read The Leapfrog Group's press release on this topic
- get Rand Health's ideas on how to build a national never event database
Related Article: CMS's McClellan tells Congress that Medicare shouldn't reimburse for never events. Article