Monday, August 20, 2007
Will Medicare Rule Changes End Up Costing the Patient?
Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals. The move will save medicare millions of dollars. (Private insurers are likely to make similar changes.) Medicare will no longer pay hospitals for the costs of treating “conditions that could reasonably have been prevented.”These conditions include bedsores, pressure ulcers, injuries caused by falls, and infections from prolonged use of catheters. Medicare also will no longer pay for treatment of “serious preventable events” like hospital fall downs, leaving a sponge in a patient during surgery or providing a patient with incompatible blood. Herb B. Kuhn is the acting deputy administrator of the Centers for Medicare and Medicaid Services. Hospital executives question who will pay the costs of these extra tests and services if Medicare does not. (Can you feel someone reaching into your pocket book?)
1.7 million infections develop in hospitals each year. Infection causes or contributes to the death of 99,000 people a year. Susan M. Pisano, America’s Health Insurance Plans, said, “Private insurers will take a close look at what Medicare is doing, with an eye to adopting similar policies.” Some fear that some hospitals will try to pass on the costs to patients. That is technically forbidden. “The hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication,” according to the Medicare rules. However, Dr. Kenneth W. Kizer, who was the top health official at the Department of Veterans Affairs from 1994 to 1999, said: “I applaud the intent of the new Medicare rules, but I worry that hospitals will figure out ways to get around them."
Only time will tell if this will hit the consumer in the pocketbook or lead to poorer health care.