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Do-not-pay policy has hospitals clamping down on errors
BY LAURAN NEERGAARD The Associated Press

    WASHINGTON — It’s a new way to push for patient safety: Don’t pay hospitals when they commit certain errors.
    Medicare will start hitting hospitals where it hurts in October, and other insurers are hot on the trail.
    That has the nation’s hospitals exploring innovative programs to prevent injury and infection: Handwashing spies. Surgical sponges that sound an alarm if left in the body. Even a room sterilizer that promises to wipe out bacteria left lurking on bedrails.
    “Money talks,” says Dr. Steven Gordon, infectious disease chief at the Cleveland Clinic Foundation. “Every hospital CFO, this gets their attention.”
    And patients’ first sign that something is changing may involve lessening of a big indignity: Today, one in four hospitalized patients is outfitted with a urinary catheter. The tubes trigger more than half a million urinary tract infections a year, the most common hospitalcaused infection.
    Yet many patients don’t even need catheters — they’re an automatic precaution after certain surgeries — and many who do have them for days longer than necessary. Why? The University of Michigan reported the first national study of catheter practices last month, finding nearly half of hospitals don’t even keep track of who gets one. Fewer than one in 10 hospitals does a daily check to see if the catheter is still needed, a simple but proven infection-reducing system.
    With those infections topping Medicare’s do-not-pay list, Gordon says hospitals already are beginning to get choosier about who needs catheters, and to yank them faster.
    Even when a hospital makes a preventable error, it still can be reimbursed for the extra treatment that patient will now require. Some errors can add $10,000 to $100,000 to the cost of a patient’s stay.
    Beginning Oct. 1, Medicare no longer will pay those extra-care costs for eight preventable hospital errors, including catheter-caused urinary tract infections, injuries from falls, and leaving objects in the body after surgery. Nor can hospitals bill the injured patient for those extra costs.
    Next year, Medicare will add three more errors to the no-pay list; ventilator-caused pneumonia and drug-resistant staph infections are top candidates.
    Medicare, which insures about 44 million elderly and disabled people, estimates the move will save the government about $190 million over five years.
    It also sparked a movement: Private insurance giants like Aetna are moving to make hospitals absorb the cost of serious errors. Pennsylvania last month said it would follow Medicare’s example and stop Medicaid payments, too. The American Hospital Association is urging members to voluntarily quit billing for treatment of serious errors, and hospitals in a number of states, from Minnesota to Vermont, have announced they will.
    Many hospitals already were trying to improve patient safety for a bigger reason — to prevent suffering and death — and a question is whether making them literally pay for mistakes will spur greater improvements. But some novel attempts are under way:
    A standard mop-and-bucket cleaning leaves bacteria in hospital rooms, especially on electronic equipment that janitors hesitate to touch. So the Wellmont Health System in Kingsport, Tenn., is testing a portable machine that sterilizes a closed room by spewing out vaporized hydrogen peroxide that reaches into every nook and cranny.
    STERIS Corp.’s VaproSure is proven to eliminate tough germs; it has long been used in sterile manufacturing facilities, and even helped clean buildings tainted in the 2001 anthrax attacks.
    Nurses count surgical sponges to make sure they’re all out before a patient is sewn up, but every hospital occasionally misses some. In University of Michigan operating rooms, doctors are testing sponges tagged with bar code-like radio frequency chips. Wave a wand and a beep sounds if a sponge is still in the wound. Or, nurses can drop used sponges into a “smart” bucket that counts how many are missing.
    There is some concern that the no-pay push could make hospitals try to hide certain errors, or just trade one problem for another. Pull a urinary catheter too soon, for example, and a fragile patient may fall going to the bathroom, says clinical affairs chief Dr. Darrell Campbell, a well-known patient safety specialist.

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Why? The University of Michigan reported the first national study of catheter practices last month, finding nearly half of hospitals don’t even keep track of who gets one. Fewer than one in 10 hospitals does a daily check to see if the catheter is still needed, a simple but proven infection-reducing system.

Alot of folks with catheters are already debilitated and need help to get to the bathroom(safety issue)--who is going to assist them? the large numbers of staff on the shift--ha ha ha ha ha ha,,,,

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Next year, Medicare will add three more errors to the no-pay list; ventilator-caused pneumonia and drug-resistant staph infections are top candidates.

staph is EVERYWHERE and EVERYONE GETS IT AND HAS IT....dirty bars, dirty needles, poor personal hygiene etc---it exists ALL OVER

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It also sparked a movement: Private insurance giants like Aetna are moving to make hospitals absorb the cost of serious errors. Pennsylvania last month said it would follow Medicare’s example and stop Medicaid payments, too. The American Hospital Association is urging members to voluntarily quit billing for treatment of serious errors, and hospitals in a number of states, from Minnesota to Vermont, have announced they will.

The government is moving in and pretending to 'care' and have it 'all together' and be our 'big protector'----yeah, just look at the governments budgets and the passings in the timely manners.....what a farce.....

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Medicare, which insures about 44 million elderly and disabled people, estimates the move will save the government about $190 million over five years.

then after the government does take over--the tax payers will complain about paying for 'those folks that make bad lifestyle choices'....the pendulum swings both ways.....

If the insurance companies wont pay for mistakes then it is logical they wont pay for the 'mistakes' choices that people make that either gets them hurt or sick.....ie: lost after hiking, smoking, drinking, overeating etc etc........

the pendulum swings both ways....and it truly will matter when national healthcare is in effect......as a taxpayer I shall not be 'responsible' for those who indulge in risky behavior---such as purchasing prostitutes......