Kevin Pho has a great piece in USA Today on Medicare’s idiotic “never event” policy. At first glance, the idea seems reasonable: don’t pay hospitals when they make preventable errors. Unfortunately, like all government initiatives, this one is being taken to absurd lengths:
Where Medicare goes wrong, however, is by extending the no-pay rules to include “reasonably preventable” complications. These currently include patient falls and hospital-acquired infections.
Pho points out that there are no studies (not one) showing that hospital-acquired infections can be cut to zero, and that one-in-three seniors suffers a serious fall every year. So, what’s the upshot? Hospitals are penalized for events that cannot be prevented:
No-pay rules punish hospitals for the inevitable.
This is not merely unfair, it is financially unsustainable for many hospitals. Medicare already pays less than cost (that’s cost, not charges) for hospital services rendered to seniors. This has driven many community hospitals who treat large numbers of Medicare patients to the verge of bankruptcy.
How does that effect the patient? It reduces access. Since 1980, about 20% of America’s community hospitals have closed their doors. There are now fewer than 5,000 community hospitals in operation, and the number is still shrinking.
Medicare has already created a dangerous primary care shortage by cutting physician reimbursement to the point that many doctors can’t afford to treat Medicare patients. Its “never-event” policy will contribute to a similar problem for hospital access.
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