Ending Extra Payment for "Never Events" -- Stronger Incentives for Patients' Safety

doi:10.1056/NEJMp0809125

Volume 360:2388-2390		June 4, 2009		Number 23

Ending Extra Payment for "Never Events" — Stronger Incentives for Patients' Safety

Arnold Milstein, M.D., M.P.H.

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PubMed Citation

On September 1, 2008, Medicare eliminated a long-standing presumptionin its payment rules that, since hospitals were doing everythingpossible to prevent complications of treatment, taxpayers andpatients should primarily bear the average cost consequenceswhen complications occurred. A 2006 law, meant to motivate hospitalsto accelerate improvement of patients' safety, constrains hospitals'ability to bill Medicare for a higher-paid diagnosis-relatedgroup when complications occur.¹ The constraint applies onlyto hospital-acquired conditions deemed "reasonably preventable"through the use of evidence-based guidelines. These initiallyincluded eight complication categories: foreign objects leftin the body after surgery, air emboli, infusion of incompatible. . . [Full Text of this Article]

Source Information

Dr. Milstein is a member of the Medicare Payment Advisory Commission and is also the chief physician at Mercer Health and Benefits and medical director of the Pacific Business Group on Health — both in San Francisco. The Pacific Business Group helps to administer the Consumer–Purchaser Disclosure Project with the National Partnership for Women and Families, where Dr. Milstein is a board member.