Paying for performance

For hospital admissions starting today, Oct. 1, Medicare will no longer pay for what are called “never events.”

Never events are those mistakes that occur in the hospital that the feds say are easily preventable and should never happen. Examples include wrong site surgery (operating on the leg instead of the arm), leaving equipment in someone after surgery, transfusion with the wrong blood type or severe pressure ulcers.

The idea behind the move by Medicare is that hospitals should have checks and processes in place to prevent such errors. And if the feds stop paying then hospitals are more likely to make sure that those checks are in place.

As with anything in health care, the new Medicare policy is not without controversy.

Some doctors and hospitals agree that wrong site surgery should never happen, but they wonder how long this list of preventable errors will get. If a patient falls in the hospital and breaks an arm is that a never event? What about hospital acquired infections?

The national Blue Cross and Blue Shield Association has endorsed the policy of not paying for easily preventable errors. But Blue Cross and Blue Shield of North Carolina is not following Medicare in withholding payment.

Despite some of the gray areas, the Medicare shift to pay for performance is an encouraging sign and one that will make hospitals safer. Hopefully more insurers follow the lead of the federal government.