In an effort to cut payments for avoidable mistakes, hospitals across the country have joined a growing movement not to charge patients or their insurers for serious, preventable errors. Since last fall, hospitals in 11 states have agreed to waive fees for certain rare errors dubbed “never events” because safety experts say they should never happen at all, reports msnbc.com.
The National Quality Forum (NQF), a health care safety advocacy agency, has identified 28 such events. The list includes so-called “wrong-site” procedures, in which doctors operate on the wrong body part, the wrong place and, in some cases, the wrong person. There are 1,300 to 2,700 wrong-site procedures performed in the U.S. each year, according to a 2006 study in the Archives of Surgery.
However, there are 39 states where patients can expect that they, or their insurance providers, still may be billed for so called “never-events”.
Only four states have agreed to waive fees for all “never events.” Other states have agreed not to charge for eight, nine or 10 mistakes, or created their own lists based on NQF standards. In Delaware and Massachusetts, for instance, the short list of non-billable errors includes artificial insemination with the wrong donor sperm or donor egg. Pennsylvania’s list adds “unexpected removal of an organ” and “unexpected amputation of a limb.”
Indiana Hospital Association officials have adopted a no-payment policy that urges hospitals to waive fees for 12 errors. Previously, they said they’d developed guidelines and shared them with hospitals for adoption.
In 2006, Medicare was billed 764 times for objects left behind after surgery, resulting in an average payment of nearly $62,000 per event. The agency was billed 33 times for patients who got the wrong blood, at an average cost of $46,000 apiece, and nearly 323,000 times for the worst kind of pressure ulcers, a preventable problem, at a cost of $40,381 apiece.
By State: States which advises hospitals not to charge for serious, preventable errors:
– Delaware
– Georgia
– Indiana
– Maine
– Massachussetts
– Minnesota
– Oregon
– Pennsylvania
– South Carolina
– Vermont
– Washington
Other:
– New Jersey
– Colorado
Insurers:
– Aetna
– Blue Cross Blue Shield
– Wellpoint