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Homework answers / question archive /  There are many pros and cons of not reimbursing hospitals for never events

 There are many pros and cons of not reimbursing hospitals for never events

Health Science

 There are many pros and cons of not reimbursing hospitals for never events. Never events are described as "foreign object retained after surgery, air embolism, blood incompatibility, stage III and IV pressure ulcers, falls and trauma, catheter-associated urinary tract infection, vascular catheter-associated infection, surgical site infection (mediastinitis) after coronary artery bypass graft, surgical site infections following certain elective procedures (certain orthopedic surgeries and bariatric surgery), certain manifestations of poor control of blood sugar levels, deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement" (slide 54). "To be included on NQF’s list of “never events”, an event had to have been characterized as: Unambiguous—clearly identifiable and measurable, and thus feasible to include in a reporting system; Usually preventable—recognizing that some events are not always avoidable, given the complexity of health care; Serious—resulting in death or loss of a body part, disability, or more than transient loss of a body function; and Any of the following: Adverse and/or, Indicative of a problem in a health care facility’s safety systems and/or,Important for public credibility or public accountability" (slide 55). "An infection that occurs after a coronary artery bypass graft can cost as much as $30,000 to treat. Similarly, the 257,412 cases of Stage III and IV pressure ulcers in 2007 (not present on admission) cost a non-reimbursable average of $43,180 per stay.  And 193,566 cases of falls and trauma cases in 2007 cost an average of $33,894 per patient" (slide 56). The example given in slide 56 demonstrates both the pros and cons of not reimbursing hospitals for never events. The con of  not of reimbursing hospitals for never events is that they are not getting the money they need to treat their mistakes on patients. However, I believe this is more of a pro than a con for hospitals, insurance companies and patients. I believe that not reimbursing hospitals for never events will help physicians and other medical professionals be more mindful and cautious of their treatments. "It also raises the possibility of changes in medical practice as doctors focus more closely to clinical guidelines and hospitals perform more tests to assess the condition of patients at the time of admission. Hospital executives worry that they will have to absorb the costs of these extra tests because Medicare generally pays a flat amount for each case. While hospital executives said the policy would require them to collect large amounts of data they did not now have" (slide 60). Slide 60 discusses both the pros and cons. The pros are that hopefully physicians and other medical professionals will adhere more closely to guidelines and protocols. The cons are that hospitals will have to run more tests in the beginning of admission and throughout hospital visits to back themselves up. However, this is coming out of their pocket so they can be more accurate, it is not coming out of the pockets of insurance companies. I believe this is a good strategy to reduce medical errors because I can see physicians and medical professionals making careless mistakes because they know hospitals will receive the money for their mistakes from insurance companies. I think this will enforce physicians to be more mindful and accurate with their decisions and advice towards patients. I think this will also bring more awareness to medical errors that are not always spoken about. I believe this will bring change for the better in Health Care. 

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