‘No pay for never events’: Where will it lead
Health care quality, Hospitals, health insurance June 7th. 2008, 11:29amThe New York state Medicaid program is the latest to announce it’s going to stop paying for some of the so-called health care that hospitals provide that, in fact, hurts more than it helps. Wrong-site surgery, anyone? Foreign object left in during surgery?
FierceHealthcare reports on the latest payer to make the seemingly common-sense move to stop paying for preventable medical errors:
New York’s Medicaid program has decided to stop reimbursing for avoidable hospital complications and medical errors it considers to be “never events.” Starting in October, it won’t pay for care related to 14 conditions, including wrong-site surgery; foreign objects left in the body; medication errors; blood incompatibility; contaminated drugs and patient disability from electric shock. Hospitals that want to receive Medicaid payments will have to prove that such conditions were present on admission to get paid for treating them. Meanwhile, the state expects to keep expanding this list.
This trend, which now includes Centers for Medicare & Medicaid Services, CIGNA, WellPoint, and lots of others, makes so much sense…and yet why does this feel like a raft of unintended consequences getting ready to be revealed?
It is regrettable that hospital administrators do not recognize, let alone deal with, the unacceptability of preventable medical errors until payers start refusing to send the checks. There’s no doubt that the financial consequences of poor practices that result in infections and other serious medical harm will get hospitals to change their ways. But at what cost? The bureaucracy that is being built up to make the “no pay” trend work will be substantial, adding to the high cost of care. And the high cost of care translates into reduced access for some patients.
Term limits for legislators seemed like a good idea until they were passed–and now they look like big problems. I wonder if we’ll say the same thing about the ‘never event’ trend some day.