WASHINGTON — It’s a new way to push for patient safety: Don’t pay hospitals when they commit certain errors.
Medicare will start hitting hospitals where it hurts in October, and other insurers are hot on the trail.
That has the nation’s hospitals exploring innovative programs to prevent injury and infection: Hand-washing spies. Surgical sponges that sound an alarm if left in the body. Even a room sterilizer that promises to wipe out bacteria left lurking on bedrails.
“Money talks,” says Dr. Steven Gordon, infectious-disease chief at the Cleveland Clinic Foundation. “Every hospital CFO, this gets their attention.”
And patients’ first sign that something is changing may involve lessening of a big indignity: Today, one in four hospitalized patients is outfitted with a urinary catheter. The tubes trigger more than half a million urinary-tract infections a year, the most common hospital-caused infection.
Yet many patients don’t even need catheters — they’re an automatic precaution after certain surgeries — and many who do have them for days longer than necessary.
With those infections topping Medicare’s do-not-pay list, Gordon says hospitals already are beginning to get choosier about who needs catheters, and yanking them faster.
Even when a hospital makes a preventable error, it still can be reimbursed for the extra treatment that patient will now require.
Some errors can add $10,000 to $100,000 to the cost of a patient’s stay.
Beginning Oct. 1, Medicare no longer will pay those extra-care costs for eight preventable hospital errors, including catheter-caused urinary-tract infections, injuries from falls, and leaving objects in the body after surgery. Nor can hospitals bill the injured patient for those extra costs.
No pay for harm
On Oct. 1, Medicare will stop paying hospitals for the care they must provide to treat eight preventable injuries:
• Urinary-tract infections from catheters
• Bloodstream infections from using catheters
• Falls
• Bedsores, or pressure ulcers
• Objects left in a patient during surgery
• Blood incompatibility, giving a dangerously wrong blood type
• Infection after heart surgery called mediastinitis
• Air embolism, an air bubble in a blood vessel
