By Amanda Sounart, associate editor
Potentially preventable medical errors may have an even higher price tag than previously thought. A new study conducted by HealthGrades, a national healthcare ratings organization, found that medical errors occurring between 2004 and 2006 resulted in approximately 238,337 potentially preventable deaths and cost Medicare an estimated $8.8 billion.
The study analyzed 41 million Medicare claims submitted for reimbursement between 2004 and 2006. The most significant risk factor found for medical error was hospital quality. Patients of hospitals, ranked as top-performing facilities by HealthGrades, were 43 percent less likely to experience a medical error than patients in poor-performance hospitals.
Last year, the Centers for Medicare and Medicaid (CMS) announced they would no longer be paying for the treatment of eight preventable errors including objects left in a patient post-surgery, air embolism, blood incompatibility, catheter-associated urinary tract infection, pressure ulcers, vascular catheter-associated infection, select surgical site infections (SSI) and specific falls and traumas that take place in the hospital. The mandate is scheduled to go into effect October 1, 2008. With a lower rate of preventable errors, top-performing hospitals are in a position to prevent billions in lost revenue and save thousands of lives.
"While many U.S. hospitals have taken extensive action to prevent medical errors, the prevalence of likely preventable patient safety incidents is taking a costly toll on our healthcare systems—in both lives and dollars," said Dr. Samantha Collier, HealthGrades' chief medical officer and the primary author of the study, in a press statement. "HealthGrades has documented in numerous studies the significant and largely unchanging gap between top-performing and poor-performing hospitals. It is imperative that hospitals recognize the benchmarks set by the Distinguished Hospitals for Patient Safety are achievable and associated with higher safety and markedly lower cost."
The organization estimates that between 2004 and 2006, $2 billion could have been saved if all hospitals performed at the highest levels of patient safety, as set by the Distinguished Hospitals programs. In addition, there would be approximately 220,106 fewer patient safety incidents and 37,214 fewer Medicare deaths.
Without a concerted effort to correct patient safety issues, these preventable errors could be costing hospitals even more in the coming years. Last month CMS announced an additional list of hospital-acquired conditions that they propose to stop reimbursement for beginning in 2009. This list includes:
- SSIs following select elective procedures
- Hospital-acquired Legionnaires' disease
- Diabetic glycemic control errors
- Iatrogenic pneumothorax
- Delirium
- Ventilator-associated pneumonia (VAP)
- Deep vein thrombosis and pulmonary embolism
- Staphylococcus aureus septicemia
- Clostridium difficile-associated disease (CDAD)
CMS will also be adding 43 quality measures for hospitals to report in order to be eligible for reimbursement.
"CMS is taking aggressive actions to ensure that beneficiaries get safe, high quality, and efficient care from their healthcare providers, and the actions we are announcing today builds on our efforts," said Kerry Weems, acting administrator of CMS, in a press statement. "The status of the Medicare Hospital Insurance Trust Fund requires us to find the best solutions to ensure that Medicare stays strong while paying providers appropriately for the care they deliver. The reforms we are proposing in this rule should lead to greater value for Medicare beneficiaries and the Medicare program."
Final ruling on reimbursements for the additional hospital-acquired conditions will be issued on August 1, 2008.
To read the full report, visit the HealthGrades Web site.
For more information on the CMS ruling, visit the CMS Web site.
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