 |
 |
|
Many Mass. hospitals will pay for errors
Federal resistance to fees forces review By Liz Kowalczyk September 17, 2007...About half of Massachusetts hospitals say they have adopted policies to waive charges for serious medical errors such as wrong-site surgery and harmful medication mistakes, and others say they plan to, amid growing resistance from government and health insurers to paying for poor outcomes. Thirty-three of 61 hospitals recently reported to a national hospital-quality organization, The Leapfrog Group, that they have voluntarily stopped charging for 28 serious and rare errors, called "never events." But consumer groups, health insurers, legislators, and employers are pushing for more far-reaching and mandatory policies as ways to reduce errors, and hospital executives said they expect to forgo payments in an increasing number of cases, including those in which patients require additional treatment because they contracted an infection in the hospital or fell in their room. In some cases, hospitals will not have a choice. Medicare, the federal insurance program for the elderly and disabled, decided last month that, beginning in October 2008, it will no longer pay hospitals for care resulting from eight complications, including falls, objects left inside patients during surgery, pressure ulcers, and three types of hospital-acquired infections. Medicare hopes to encourage hospitals to do more to prevent these errors. Insurers often follow Medicare's lead, and the three largest Massachusetts insurers said they are reviewing the issue. State Senator Richard T. Moore, an Uxbridge Democrat, has filed legislation that would, among other measures, prohibit hospitals from charging for "never events," which were developed by the National Quality Forum, a nonprofit organization based in Washington, D.C. In addition to wrong-site surgery and serious medication errors, never events include leaving a foreign object in a surgery patient, discharging a baby to the wrong mother, and falls that result in death or serious disability. This summer, The Leapfrog Group, a Washington-based coalition mostly of large employers, began posting on its website which hospitals handle never events appropriately, including waiving charges. Beth Israel Deaconess Medical Center, Caritas Christi Health Care, Cambridge Health Alliance, and Tufts-New England Medical Center are among those listed as waiving costs directly related to never events. Massachusetts General Hospital, Brigham and Women's Hospital, Lahey Clinic, UMass Memorial Health Care, and Children's Hospital Boston do not have such policies yet - though many hospitals waive costs in cases where the mistake is egregious and clearly caregivers' fault. "Why should we pay for something that a hospital has allowed, through lack of action or lack of adequate personnel, to happen under their watch?" Moore said. But doctors and hospital executives who are struggling to develop policies said it is not that simple. Even hospitals with policies do not always agree on what constitutes a never event or what costs to waive. Read more at bostonglobe.com |