State to stop paying costs of preventable medical mistakes
By Stephen Smith, Globe Staff
Massachusetts health officials this afternoon outlined a plan to stop paying doctors and hospitals for services related to their serious medical mistakes, such as surgery on the wrong limb or giving the wrong medication.
In a statement, representatives of four agencies said Massachusetts is the first state in the nation to adopt a policy prohibiting the use of state dollars to reimburse institutions and physicians for error-related care.
The four agencies -- the Office of Medicaid, also known as MassHealth; the Group Insurance Commission; the Commonwealth Health Insurance Connector Authority; and the Department of Correction -- directly insure or pay for care for more than 1.6 million people in Massachusetts.
The decision represents the state's latest attempt to reduce errors as well as infections inside healthcare facilities. In a study published in 2006 in the journal Health Affairs, researchers estimated the extra cost of treating serious errors ranged from an average of $700 per case for preventable bed sores, to an average of $9,000 per case for body-wide infections happening after surgery.
In September of last year, several leading Massachusetts hospitals announced that they would waive fees associated with errors.
The state policy will apply to 28 serious reportable medical errors identified by the National Quality Forum, a coalition of physicians, hospitals, businesses, and policymakers.



So when Massachusetts wrongly convicts someone and imprisons that person for decades.... will the State pay that person expected back wages, appreciation for the home that the person was denied.. etc etc.. just curious...
In Mass. we have a wrongful conviction statute. Just in case you wanted to know.
Complications such as infection are not necessarily the result of error. In fact, there is a poor correlation between error and complications in medical care. Most errors result in minimal additional morbidity whereas the overwhelming majority of complications occur despite EVERY best effort to prevent them. Infection, bleeding, scarring, injuries to nerves, hospital-acquired complications, etc. are inherent risks of undergoing surgery, and if standard techniques are employed to try to prevent them and they occur anyway, it is unconscionable to deny payment to the physicians for their efforts in caring for the patient. People think NOTHING about paying a veterinarian thousands of dollars for surgery on their pet (out of pocket) but will try to duck out the back door to shirk a $20 copay.
So does that mean the doctors and hospitals have the right to turn around and sue the patient for the money the state does not pay?
As an employee of a major health insurance company in Massachusetts, it sickens me that we fork over $83,000 when a doctor opens up the patients left knee, when the surgery was supposed to happen on the right knee...
Just saying....
Yes, deny payment for doctor errors. That will make errors less likely to happen. Oh wait, no it won't. It will just shift the burden of payment to the patient (now victim). Way to solve the budget crisis...
This is not about the "inherent risks of undergoing surgery." Look at the list of events that will not be paid: http://www.mass.gov/eohhs. The list includes things that should never happen in health care--operating on the wrong body part, giving someone the wrong blood type, leaving a sponge in a patient. Taxpayers should not pay physicians and hospitals for these clear mistakes.
The state (and the federal government through Medicare, which actually has employed a similar policy starting this year) are able to invoke this since they, unlike commercial third party payers, have the right to unilaterally mandate what they will and will not pay for. In principle, there are few that would argue that blatant mistakes -- wrong site surgery, foreign bodies left in, etc. -- for which many processes have been built into the system to prevent -- should be paid for. However, almost all physicians and those with clinical knowledge will agree that there are come 'complications' on the list that are NOT usually due solely to poor care but also reflect the underlying status of the patient, contributed to in some cases by how poorly we take care of ourselves (i.e., an obese patient is more likely to get a bedsore than a patient of normal weight; should the hospital pay for this 'complication' which the patient's lifestyle has contributed to perhaps equally or more than his care in the hospital? I am at least heartened by the fact that the state is not going to pay for mistakes for those it contracts with for services. It is just too bad they waited until after the Big Dig (into taxpayers packets) was completed. We would have had quite a budget surplus if we were to be equally reimbursed for the mistakes we as a state paid for in that project.
DST, why would the patient pay? The physician would just not be paid and or the hospital should suck up the cost. The state or any insurance plan should not pay for this type of error
We can afford a lot of things - by leaving Iraq. Jus think of all the money we will save and can apply to real problems such as these.
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