Hospitals in almost fifty percent of states in the nation now say they will not bill patients for the worst kinds of medical mistakes. These mistakes are often called “never mistakes” since these events should never happen, such as operating on the wrong person, operating on the wrong body part, or giving a patient the wrong type of blood. Many feel it is unthinkable that the patient would have to pay for these mistakes. A new review shows Tennessee is among twenty-three states who have agreed on non-payment policies for specific mistakes, with at least three more expected to do so by fall. Hospitals in eight other states are going on a case-by-case basis to decide whether or not the bill should be eliminated. Remaining states have yet to adopt any of these policies even after patients are dying each year due to these medical mistakes.
It is unclear how many private patients or their insurers are still billed for medical mistakes. However, a July study by the federal Agency for Healthcare Research and Quality estimated that avoidable errors that occur during or after operations may cost employers about $1.5 billion annually. This idea of cutting payments for avoidable errors has gained steam in the past year since federal officials announced, starting October 1, Medicare would no longer reimburse hospitals for the additional costs of treating injuries, complications and infections that occurred after the patient was admitted. This month, the Medicare officials expanded the list of eight errors for which it will not pay, augmenting one and adding two more: surgical site infections after elective orthopedic and bariatric operations; severe complications from poorly controlled blood sugar; and deep vein thrombosis or pulmonary embolism following total knee and hip replacement surgeries. Additionally, the agency asked that Medicaid directors nationwide implement the non-payment policies already set forth in Massachusetts, New York and Pennsylvania. Many of the nation’s largest medical insurance providers, such as Cigna, Aetna and Blue Cross Blue Shield, are also no longer paying for serious, preventable mistakes.
Health officials are contending that cutting payments for medical errors is not as simple as it may seem. They claim that not every mistake on the list is the fault of the hospital. They agree that putting the wrong type of blood in a patient constitutes a medical error that the patient should not be billed for; they do not, however, think it is fair that a medical device’s failure, due to a manufacturer defect, can leave the hospital liable. It is also unclear how the billing process will work. If a patient is hospitalized for three weeks and an error occurs during the third week, should the patient be billed for the first two weeks of care? Also, it is a possibility that cutting payments will result in some providers avoiding certain patients that would be susceptible to pressure sores, for example. Clearly, there is no one size that fits all for this problem, but it seems to be only fair that the costs for any procedure where an error occurs, and any related or resulting care from that error, should be born by the health care provider. Let’s hope that most, if not all, hospitals and health care professionals ultimately arrive at this decision.
Below are listed 28 medical errorss that should never occur:
28 errors that should never happen
The National Quality Forum, a nonprofit health care safety agency, has created a list of 28 so-called “never events” that detail avoidable errors. The list includes the following injuries, infections or conditions:
1. Surgery on the wrong body part.
2. Surgery on the wrong patient.
3. Wrong surgical procedure performed on a patient.
4. Object left in patient after surgery.
5. Death of patient who had been generally healthy during or immediately after surgery for a localized problem.
6. Patient death or serious disability associated with the use of contaminated drugs, devices or biologics.
7. Patient death or serious disability associated with the misuse or malfunction of a device.
8. Patient death or serious disability associated with intravascular air embolism.
9. Infant discharged to wrong person.
10. Patient death or serious disability associated with patient disappearing for more than four hours.
11. Patient suicide or attempted suicide resulting in serious disability.
12. Patient death or serious disability associated with a medication error.
13. Patient death or serious disability associated with transfusion of blood or blood product of the wrong type.
14. Maternal death or serious disability associated with labor or delivery in a low-risk pregnancy.
15. Patient death or serious disability associated with the onset of hypoglycemia, a drop in blood sugar.
16. Death or serious disability associated with failure to identify and treat hyperbilirubinemia, a blood abnormality, in newborns.
17. Severe pressure ulcers acquired in the hospital.
18. Patient death or serious disability due to spinal manipulative therapy.
19. Patient death or serious disability associated with an electric shock.
20. Any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated by toxic substances.
21. Patient death or serious disability associated with a burn in the hospital.
22. Patient death associated with a fall suffered in the hospital.
23. Patient death or serious disability associated with the use of restraints or bedrails.
24. Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist or other licensed healthcare provider.
25. Abduction of a patient.
26. Sexual assault on a patient.
27. Death or significant injury of a patient or staff member resulting from a physical assault in the hospital.
28. Artificial insemination with the wrong donor sperm or donor egg.
Source: National Quality Forum.