No payments for care caused by errors

March 1, 2008

Insurers, including Aetna, Wellpoint, and others, are moving forward with plans to stop paying for care and to prevent patients from being charged for care associated with serious errors-especially preventable ones.

Insurers, including Aetna, Wellpoint, and others, are moving forward with plans to stop paying for care and to prevent patients from being charged for care associated with serious errors-especially preventable ones. These mistakes could include the death or serious disability of a mother in a low-risk pregnancy, nosocomial bedsores, discharging an infant to the wrong person, or performing the wrong procedure, among others.

Some in the industry worry that the strategy could cause medical costs to rise as hospitals pass along or absorb expenses for putting in place safety and screening procedures to prevent errors. There is also concern that providers "may find ways to turn away or divert patients at greatest risk of developing infections or bedsores," reported The New York Times (1/15/2008).

Insurers say triggering safety improvements within hospitals and reducing medical costs are the goals of their plans. The strategy also puts them in line with the Medicare program: In October, Medicare will stop paying for the extra costs associated with preventable injuries or infections that occur when a patient is in the hospital.