Payers Should Reward Hospitals That Are Serious About Patient Safety

This article is another example of how health insurance payers are putting more pressure on hospitals to reduce unnecessary errors as a condition for reimbursement. This raised level of accountability for quality and patient safety improvements will benefit us all in the long-term, and is something that is long overdue. However, we'd like to see payers push for a more robust set of hospital quality measures and the presence best practices, and tie their reimbursements to them consistently. For example, a hospital that is consistently using systematic external peer review (a best practice which too few hospitals follow today) should be rewarded with better reimbursements than one that is not, since they're not meeting the intent of the new Joint Commission standards for focused and ongoing professional practice evaluation.

Featured Story February 21, 2008

More Health Plans Adopt 'Never-Event' Policies That Don't Reimburse for Treatment Needed to Correct Medical Errors

Reprinted from HEALTH PLAN WEEK (formerly Managed Care Week), the industry's leading source of business, financial and regulatory news of health plans, PPOs and POS plans.

More payers say they are adopting so-called "never-event" payment policies, under which providers will not be reimbursed for procedures and treatments needed as a result of certain preventable errors made in hospitals. But choosing which errors to focus on, incorporating language into hospital contracts and auditing hospitals' claims can pose challenges, experts warn.

Read the rest of the article: http://www.aishealth.com/Bnow/hbd022108.html