Tuesday, February 24, 2009

Employers Support Non-Payment for Hospital-Acquired Infections

/PRNewswire/ -- The non-profit Midwest Business Group on Health (MBGH) released the results of a survey of employers and health care industry stakeholders on their knowledge and intentions to improve the safety and quality of health care by no longer paying for "never events" - serious and costly preventable hospital errors and hospital-acquired infections. The findings were presented at a meeting of key health care industry stakeholders including public and private employers, hospitals, health plans, doctors, consumer organizations and government hosted by MBGH in Chicago last week.

"There are currently several separate efforts taking place in our community aimed at reducing hospital-acquired conditions," said Larry Boress, president and CEO of the MBGH. "We invited key stakeholders to come together for an in depth discussion on "never events" in the hopes that we can bring continuity to these efforts and make faster progress toward improving the safety and quality of health care for everyone."

Survey findings
-- More than 60 percent of employers believed they should pay for
conditions that arose after the covered patient was admitted to a
hospital, if the facility was not at fault.
-- However, once employers became aware that Medicare had identified
conditions which should never happen to a patient and will not pay for
services related to such situations, close to 80 percent of health
care purchasers agreed that their health plans should adopt the same
payment policies as Medicare related to those conditions.
-- Nearly 100 percent of employer respondents indicated hospitals should
refrain from billing patients for services not paid for by their
benefits for events that experts say should not happen in a hospital.
-- Sixty-eight percent of employers agreed that MBGH should bring
together plans, hospitals, employers, consumer and government agencies
to define and address as a community what conditions hospitals should
focus on from the "never events" and Medicare hospital-acquired
conditions lists.

MBGH is a Regional Roll-Out Leader for The Leapfrog Group and is actively involved in hospital performance and public reporting efforts in Chicago, including the Leapfrog Hospital Survey. A section of this survey addresses 28 serious preventable errors or "never events" as set forth by the National Quality Forum (NQF). Currently, less than 47 percent of hospitals in Illinois participating in the Leapfrog Hospital Survey have agreed to meet the Leapfrog "never events" policy. Efforts are also being looked at by national groups to consider payment policies that refrain from paying for such events in physicians' offices.

"Most small- and mid-size employers are unaware of the impact of "never events" to their growing costs for health care," said Joseph Balasa, chief operating officer for the Chicagoland Chamber of Commerce. "We are looking to the large employers, hospitals and health plans to make progress in solving this problem so the entire community can benefit from improved quality and safety of health care."

MBGH's survey and the meeting were supported by sanofi-aventis. The survey was submitted electronically, with more than 50 employers and other health care stakeholders responding. More than 160 people participated in the meeting.

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