New Policy on Hospital-Acquired Problems: Medicare/Medicaid Won't Pay

If you go into the hospital, you have a one in 10 chance of something going wrong or picking up some bug that you didn’t bring in with you, according to the Centers for Disease Control and Prevention.

That number seems pretty high to the Centers for Medicare and Medicaid Services, so it announced about six weeks ago that after Oct. 1, it won’t be paying for the costs associated with fixing mistakes and treating hospital-acquired infections.

This decision won’t affect patients’ bills; the hospital will have to absorb the costs.

If you haven’t yet seen it, here is the CMS list of hospital-acquired problems for which it won’t pay:
• Foreign object retained after surgery
• Air embolism
• Blood incompatibility
• Stage III and IV pressure ulcers
• Falls and trauma
• Fractures
• Dislocations
• Intracranial injuries
• Crushing injuries
• Burns
• Catheter-associated urinary tract infection
• Vascular catheter-associate infection
• Surgical site infection-mediastinitis after coronary artery bypass graft

To come: an additional list of eight conditions for which CMS will not reimburse hospitals. They include:
• Surgical site infections following these elective procedures: total knee replacement; laparoscopic gastric bypass and gastroenterostomy; ligation and stripping of varicose veins.
• Legionnaires' disease
• Glycemic control problems - diabetic ketoacidosis; nonketotic hyperosmolar coma; diabetic coma; hypoglycemic coma.
• Iatrogenic pneumothroax
• Delirium
Ventilator-associated pneumonia
• Deep-vein thrombosis/pulmonary embolism
• Staphylococcus aureus septicemia
• Clostridium difficle-associated disease

Do you agree with CMS’ decision to cease paying for hospital-caused problems?

What measures or changes are being implemented at your workplace to decrease the incidence of hospital-acquired problems?

Do you think they will work?

Tell us what you think.