Anthem will no longer pay for preventable medical errors
Anthem Blue Cross Blue Shield in New Hampshire announced Thursday that it no longer pay preventable medical errors.
The hymn called at the initiative of a move to the elimination of the most important preventable adverse events of health care to reduce costs in the health sector.
From the viewpoint of Donna Fitts, Vice President of Quality and Risk Systems Portsmouth Regional Hospital, the decision of a large insurance institution is a positive effect on hospitals in the state, including their own.
“It will require us, in a medical environment very animated, and stop making an inventory of things we are doing,” said Fitts. “It is quite clear that many of these things are errors that occur, should never enter a hospital.”
Évitable significant medical consequences in the sense of events by the Centers for Medicare and Medicaid Services and the National Quality Forum includes such things as:
Surgery at the wrong place.
Surgery, patients on the coupon.
Poor operation, the patient.
Retention of a foreign object in a patient after surgery or other procedures.
The first phase of the initiative of the hymn composed of 11 major preventable adverse medical events, and are modified and expanded in the future. In addition, changes are Anthem’s help to ensure that payment will be made and no additional burden, if any of these events:
Air embolism or blockage.
Blood inconsistency.
Catheter associated with urinary tract infections.
Escarres, ulcers (pressure).
Vascular Catheter-associated infections.
Médiastinales (chest infection) after coronary artery bypass graft operation. The hospital acquired injuries as fractures, dislocations, intracranial injuries, crushing injuries and burns.
Fitts said they would wait for the royalties arising from these situations are absorbed by the hospital, and not to individual patients.
“I can not imagine every hospital in the year 2008 would be to think that the billing patients for the lower limb amputation a forgery, for example,” she says. “It would be morally and ethically wrong to the bill by mistake for an error that we have. ”
Anthem Blue Cross Blue Shield of New Hampshire pointed out that this decision is an attempt to transfer money from the impact of medical errors extremes of those who are bound.
“The main focus of this effort will be to ensure that doctors and hospitals must establish procedures, technologies and strategies for dealing with” never events “and, ultimately, improving the quality care for patients at the hospital, “said Richard Lafleur, MD, Medical Director, Anthem Blue Cross Blue Shield in New Hampshire.” We are working with doctors and hospitals to analyze why and how such events occur , and is working to find ways to improve patient safety and clinical care. ”
In addition to improving patient safety and quality of results, Lafleur added that the initiative will contribute to the protection of members of the anthem of additional costs generated by medical errors.
“As a strong advocate of patient safety, we have a responsibility to our members to work with our partners in the hospital, in the locality of the process, covering such events to prevent,” says Lafleur.
Anthem initiative is in the early stages of implementation. This allows the company to continue to play in collaboration with hospitals, Verhütbarkeit of these events, as quickly as possible, and monitoring of activities related to the events list from the Federal Constitution, State and private providers, the adjustments are deemed necessary and reasonable.
“Ode to intensify efforts focus on patient safety and work in the direction of the hospital to eliminate and prevent errors were commendable, and with our objectives for a health system safer, the new direction paying themselves on the basis of safety and quality, “said Mike Hill, president of the New Hampshire Hospital Association. “It is important for our industry to find ways to systems issues that happen avoidable mistakes, and conducted in collaboration with The anthem of our public hospitals to help us move in the right direction.”