TodayMedicare seeks accountability
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Article RatingMedicare officials say that no longer paying for the treatment of “preventable” errors will save the government billions of dollars - so much so that private insurers are looking at taking a similar step, the Associated Press reported over the weekend.
Holding hospitals and physicians accountable in this way also could lead to better health care and save lives.
Medicare is to publish new rules this week stating that it will not cover a number of conditions ranging from hospital-acquired infections and injuries caused by falls to bedsores and leaving objects behind in surgical patients.
And the health care providers will be banned from passing the costs along to the patient.
In other words, good facilities and health care professionals have extra incentive to improve on the best practices they already follow and the others will be pushed to clean up their acts.
This change could have a significant and immediate impact.
Consider the serious problem of hospital-acquired infection. The Centers for Disease Control and Prevention estimates that patients develop 1.7 million infections in hospitals each year, and it says those infections cause or contribute to the death of 99,000 people a year - about 270 a day.
Yet the vast majority of these cases can be prevented easily and cheaply, simply by following basic hygiene such as frequent hand washing and use of sterile gowns. Most of the other preventable injuries and conditions Medicare is targeting also fall under that “common sense” rubric.
Critics of the new plan worry that hospitals will be held responsible for infections patients bring into the hospital with them undetected and, as a result, will begin ordering more tests upon admission - thus raising costs. They also say that the extra tracking of data that will be required will be costly.
Advocates also have expressed concern that hospitals will try to find some way around the new rules instead of using them as a spur to betterment.
But we believe the majority of hospitals and health care professionals already want to do right by the people in their care. This new step on the part of Medicare should help ensure that everyone follows procedures - and the data sure to result will allow further improvements across the board.
Pennsylvanians already have one such tool, thanks to the state Health Care Cost Containment Council, commonly known as PHC4.
Last year's report on hospital-acquired infections, for example, provides a baseline for facilities across the state on how well each is doing. Over time, as this is tracked, patients will be able to decide for themselves - on this and in a number of other areas where quality can be measured - whether they want to use a particular hospital or clinic.
It's basic economics.
With informed patients applying pressure at the grassroots level and Medicare and private insurers wielding financial pressure from above, the likelihood increases that patients will actually benefit from the health care they seek rather than going home worse off than before.
