I’m not sure whether to stand up and applaud — or to begin worrying even more about patients who are hospitalized….
Beginning in October 2008, Medicare (CMS: Centers for Medicaid and Medicare Services) will no longer pay hospitals for any extra care a patient needs if that patient acquires any of three types of infections while hospitalized (NOT including MRSA), or five other non-infection related mistakes or “accidents”, including bedsores, falls, or objects left inside a person’s body.
The basis for the new law is this: if hospitals know they won’t get reimbursed, then they will be more likely to make sure those things don’t happen. The current statistics tell us that 2 million patients acquire a hospital infection each year, that 100,000 of them die — and other medical mistakes account for up to 100,000 American deaths per year.
Knowing that American healthcare is not about health or care, it’s about sickness and money — the new law makes sense. I applaud the efforts of Medicare to address preventable infections and errors!
But — I do see a few problems — no answers — but sometimes asking the questions makes us aware of the problems that might occur….
Why isn’t MRSA (methicillin-resistant Staphylococcus aureus) included as one of the 8 conditions? It’s a superbug that is 99% acquired in hospitals. Patients can be tested before they are admitted, so hospitals will know if a patient has MRSA…. and it will be obvious if it is acquired while a patient is in their care. The press release says it’s because “not everyone believes MRSA can be prevented…” — and I say to that — yes it can! Steps taken in Europe show that hospitals CAN clean up their acts enough to get rid of MRSA.
Just because Medicare will stop paying doesn’t mean those errors won’t happen. So how will hospitals pay for them? They may happen less frequently — but they will still occur! So how will they get paid for?
It seems to me the rule of unintended consequences will kick in big-time here. Some possibilities: the real causes of problems will be covered up (fraud — yes, fraud), the charges will end up on the patient’s bill in some convoluted way (even though the new regulations expressly forbid it.) Hospitals unable to keep up with these new costs will close down, leaving patients who need services in the lurch — an even bigger problem in rural areas where other hospitals are not available….
It’s not that I don’t think Medicare is making a real, bona fide effort at improving safety for patients in hospitals — I do. I’m just not positive that their “smart” decisions won’t end up being even more costly for us all in the long run.
A copy of the new CMS regulations can be found here (begin at page 290):
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