Making Hospitals Pay For Own Mistakes

(CBS)  William Doyle survived his open-heart surgery - but was almost killed, days later, by a hospital mistake, CBS News correspondent Wyatt Andrews reports.

"At the time, I very easily could have died from this infection," Doyle said.

It was a chest infection, caused by a breakdown in hospital cleanliness. After a second operation and months of extra care, the bill to treat his infection was almost double the charge for his surgery.

As Doyle noted, the complication was more expensive than original problem.

What to do about big, expensive hospital mistakes is a question about to be answered in a revolutionary way. Both the Medicare system and several large insurance companies have said they won't pay hospitals any more for certain preventable errors.

Beginning in October, Medicare will no longer pay for eight hospital mistakes - including:

Urinary infection from catheter

Bed sores

Surgical object left in body

Air embolism

Giving wrong type of blood

Blood infection from catheter

Chest infection after bypass surgery

Hospital-caused injury

"We think it's a big deal," said Kerry Weems, Medicare's acting administrator. He says when the system stops paying for preventable mistakes, hospitals will stop making them.

"And that's what this is really about, avoiding errors and improving the quality of care for everybody," he said.

One state, Pennsylvania, is already refusing to pay for errors.

It's Medicaid program lists 27 mistakes called "never events," including "surgery done on the wrong body part" and medication leading to injury or death.

Medication error is what almost killed the twins born to actor Dennis Quaid and his wife Kimberly. They told 60 Minutes correspondent Steve Kroft how the twins got massive overdoses of the blood thinner heparin.

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Read Steve Kroft's full 60 Minutes report.

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And "never event," said Governor Ed Rendell, means the state will never pay.

"Its not just about constraining costs, its about saving lives," he said. "Preventable medical errors cause more deaths in this country than Alzheimer's, diabetes, almost to the level of stroke. That's stunning, isn't it?"

Already some innovative hospitals are working to eliminate mistakes. Before every bypass surgery, surgeons in the Geisinger Health System in Pennsylvania use a 40-step safety list.

And if there is any error, the hospital pays. No added expense are charged to the patient or insurance company. It's like a warranty, and after two years, they say it's working.

"We've had fewer complications, fewer mortalities, generally all these clinical outcomes are moving in the right direction," Dr. Ronald Paulus of the Geisinger Health System said.

For decades, the U.S. health care system has paid doctors and hospitals by the services performed, even if those services harmed the patient.

To many experts the real question is: Why did it take so long to stop paying for preventable mistakes?

[revinheart]

Baloney the avenue provided for a consumer to complain and get anyone to do anything about medical mistakes is about as acurate as this report . For anyones information any complaint done in Pa will take from 3 months to a year to resolve and they say nothing about stopping the medical bill collectors .This has to be a country going mad ,your suppose to pay for medication that makes you go to er and your suppose to pay for the misdiagnose of the er that puts into a life or death conditon .Where is the sense have we, lost our minds?who do you complain to. because no greedy lawyer will consider this a case ,there is something wrong with this ?but who will fix this problem?

[bloggerbud]

Two of these rules are really going to backfire.
People can get infections from catheters either in the bladder or in the blodd though absolutely no fault from anyone. It just happens when you put a foreign body into someone.

Now we will have to give antibiotic to everyone with a line in place in order to try and protect against this "error". That will cause folks to get antibiotic resistance and really raise costs.

Not paying for an error will not make it go away, Folks. This is a bad, bad road we''re going down.

[alarchdu]

Why would a hospital admit to making mistakes? UK and Australian hospitals hate to admit to making mistakes resulting in "adverse reactions" such as hospital-acquired infections, when the only outcome is bad publicity. You expect them to admit to mistakes that cost them money? From my viewpoint Downunder, this approach seems just another way of health funds exercising control of hospitals for financial benefit, not patient good health.

Neville J. Angove

[Netterz]

Its already on the hospital papers you sign. You are responsible for any and all bills NOT paid by your insurance co. So, unless you have the time, money,and good lawyers, are you going to survive this latest way Corp America has worked hard to destroy your credit,so they can then charge you unreal fees and interest rates, and continue the constant raping of your wallet ,every scond of every day. When the Gov''t says they will NOT be allowed to bill the patient, or there family they left behind, I ill fall over dead on the spot.

[cyberus-2009]

Medicine (human and veterinary) are one of the few industries that can profit from mistakes .. construction is another.

About time someone started making them take responsibility for their errors without requiring a court battle.

Now (IMO) the states need to implement some law to prevent (as someone mentioned) billing of the people that were hurt after the state/insurance company refused to pay.
Perhaps a "civilian review board" TYPE system should be instituted. 2 civilians, 2 medically trained reviewers, 1 medical law judge as arbitrator/tie breaker. A "instrument left in body" case would get a "surgical error" rubberstamp .. an infection case (as someone mentioned earlier) could be reviewed to see if it was error or a case of "grandkids with dirty hands visiting".

[godseyesore-2009]

If insurance refuses, then insurance company should bear cost of suing hospital and/or physician(s). If companies win, hosp/phy pays. Lose, insurance company pays.
What''s the big deal?

[dehulsey]

In 1992 my 55 year old father went into Tuscaloosa, AL''s only hospital, DCH, for hemmorhoid surgery and died 5 weeks later of Strep infection he got while in the hospital. That place was and still is unclean. I think this is good news. We need our hospitals clean.

[tlparp]

Refusing to pay for mistakes is one thing, refusing to pay for bad outcomes is another thing entirely. I''m a nurse in an intensive care unit, and I see infections and bad outcomes every day. But a lot of these bad outcomes are not preventable, they are a result of people being horribly sick before they ever get to the hospital. I see the staff washing their hands repeatedly and using the hand sanitizer provided. But then I see a patient''s family member hug the patient, walk out of the room, push the button to open the door, then push the elevator button as they leave. Then the next family member comes in, pushes the elevator button, opens the door, enters their family member''s room, hugs them. The germs from the first patient just left his room, went for a ride down the elevator, then came back up and into the 2nd patient''s room. I as a nurse can wash my hands 500 times a day, but all it takes is one family member shaking hands in the lobby with another family member, and then not washing their hands. I''m not blaming families for the problems, I just don''t think we can prevent every infection, and somehow it doesn''t make sense to me to refuse to pay for something that we as healthcare providers have little control over.

[revinheart]

So wheres the sign wash hands before greeting patient ,even after that air is not inocuous.some patients will fall through the cracks.litterally.but misinforming patient .mis diagnoses is wrong ,were dealing with human beings,not a used car. Otherwise people are gong to go to get medical treatment on a last situation. It shouldnt be that way .A nation that cant provide its people with good affordable healthcare can not prosper or have productive citizens.

[captandrea]

My father was infected with MRSA staph infection while undergoing a repair job to a "minor" heart (Leaky Valve) surgery. The surgeon had knicked the pericardium during the original procedure. As a result he had to undergo multiple additional open heart surgeries leaving him in Cardiac ICU for 3 months - most of the time in a drug induced coma with his chest wide open. Somehow he survived this ordeal and was finally returning to a normal life after 3 years of recovery, only to be diagnosed with leukemia, and to lose his life in 2004..

[janetp1974]

Dvillegas43 has it right. My mother died due to chemotherapy improperly administered in one of those PA hospitals. The nurse did not get the pre-chemo meds into the port properly and they leaked onto the bed. The call button was hung on the wall, out of reach. And there was one nurse on duty for 15 chemo patients. She quit breathing and was taken to the ER, where they worked for 15 minutes to get her going again. She had to go to a nursing home, and died not long after. Yet they tried to get us to pay the aborted chemo session and the ER and ICU charges.