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Hospital complications: linking payment reduction to preventability.

Richard E Averill¹, John S Hughes, Norbert I Goldfield

¹Clinical and Economic Research, 3M Health Information Systems, Inc., Wallingford, Connecticut, USA.

Joint Commission Journal on Quality and Patient Safety

|June 2, 2009

Summary

The Center for Medicare & Medicaid Services (CMS) payment policy for in-hospital complications needs revision. Some complications are unavoidable, making denial of payment inequitable for healthcare providers.

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Area of Science:

Healthcare Policy
Medical Economics
Patient Safety

Background:

The Center for Medicare & Medicaid Services (CMS) currently denies payment for specific in-hospital complications.
This policy assumes that all such complications are preventable and attributable to provider error.
Such a policy impacts healthcare reimbursement and provider financial stability.

Purpose of the Study:

To evaluate the Center for Medicare & Medicaid Services (CMS) policy on denying payment for in-hospital complications.
To determine if the policy adequately considers the preventability of complications.
To advocate for modifications to the CMS payment policy.

Main Methods:

Policy analysis of the Center for Medicare & Medicaid Services (CMS) guidelines.
Review of medical literature on the preventability of in-hospital complications.
Case study analysis (if applicable, though not detailed in the abstract).

Main Results:

In-hospital complications are not universally preventable.
Factors beyond provider control contribute to the occurrence of certain complications.
The current CMS policy may unfairly penalize providers for unavoidable adverse events.

Conclusions:

The Center for Medicare & Medicaid Services (CMS) policy requires modification to acknowledge that not all in-hospital complications are preventable.
Reimbursement policies should differentiate between preventable and non-preventable complications.
A revised policy would ensure fairer financial practices in healthcare settings.