Never Events No Longer Chargeable
In a recent article published by the American Medical Association News, more and more hospitals and insurers are working together to discontinue charging for never events. The healthcare community is additionally making strides to ensure that this encourages improved safety.
Among the events that fall into the so-called “never” category include wrong site and wrong patient surgery, items left in body cavities after surgery, or sending an infant home with the wrong family. The National Quality Forum (NCF) identified 28 different never events which also include hospital-acquired conditions such as air embolism, patient falls, and blood incompatibility. It originally identified 27 events in 2002 and updated the list in 2006.
Last November, the BlueCross BlueShield Association announced that they plan to discontinue payment to providers and healthcare facilities for these types of events. To that end, the company is planning modifications to claims and coding procedures which will be rolled out over the next few years.
Hospitals are also stepping up to the plate to address this safety and quality consideration. Last September, Minnesota hospitals announced that never events should not be billed to either insurers or patients. Over sixty facilities in Massachusetts followed suit in December, announcing that nine of the NQF events will not be charged. In all, almost 1,300 hospitals across the country are adopting this standard.
At the end of last summer, the Centers for Medicare and Medicaid Services announced that beginning October 2008, the agency will cease payments for five different hospital-acquired events identified by NQF. This was described on HospitalBuyer.
This momentum in safety accountability indicates the ongoing efforts in the healthcare community to reduce the incidence of errors. The implications of non payment for such events places even more pressure on providers to mitigate the possibility of these occurrences, however rare.
Nevertheless, some caution is required for events that are simply out of the provider’s control. One example of such is patient falls. A balance is required for these accountability efforts to be effective. The goal is to both reduce events and simultaneously create a culture that encourages reporting. Reporting never events, as well as other adverse events, is the key to developing protocols to reduce the incidence of such.
January 4, 2008 Related topics: Trends, Quality, Safety, Errors