Medicare officials have added hospital-acquired conditions to the list of conditions for which the program will not pay higher hospital payments to treat. The Centers for Medicare & Medicaid Services (CMS) says the three new conditions are:
- Surgical site infections following certain elective procedures;
- Extreme blood sugar derangement; and
- Deep vein thrombosis or pulmonary embolism following total knee or hip replacement procedures.
American Medical Association President-Elect Jim Rohack, MD, said the decision "puts patient care at risk. We are working hard to improve quality and efficiency , but simply not paying for complications or conditions that while regrettable are not entirely preventable is not the way to do it. It is unacceptable that this program is being expanded beyond the original eight conditions identified last year for nonpayment when the first phase of the program has not even begun."
Dr. Rohack, a former TMA president, said Medicare officials "are confusing events that should never happen in a hospital, like wrong-site surgery, with often unavoidable conditions, like surgical site infections" in their race to improve health care quality. "To be reasonably preventable, there should be solid evidence that by following guidelines, the occurrence of an event can be reduced to zero or near zero. This is not the case for many of the now-banned conditions," he said. "Focusing on determining whether or not medical conditions exist when the patient enters the hospital will increase Medicare spending on tests and screenings with questionable benefit to patients. A more effective patient safety approach would be to encourage compliance with evidence-based guidelines by health care professionals."
Action , Aug. 18, 2008
Last Updated On
May 13, 2016
Originally Published On
March 23, 2010