Medicaid Expands Never Events To Lessen Costs and Medical Mistakes

Medicaid published a new rule recently expanding their list of “Never Events” to be aligned with Medicare’s and many states nonpayment policies. These “Never Events” are largely preventable and will now be denied nationwide should a health care professional or facility seek payment for a patient’s treatment. Unless it is documented during a patient’s admission, health care facilities will not be reimbursed by Medicare or be able to go after costs from the patient.

For example, the Centers for Medicare and Medicaid Services (CMS) said that an estimated 40-percent of hospital admissions were preventable when nursing home residents were put into their care, and 314,000 potentially avoidable hospitalizations and $2.6 billion in Medicare expenditures could have been saved. The updated list seeks to align Medicaid and Medicare policies, increase the quality of health care, and cut costs.

“These steps will encourage health professionals and hospitals to reduce preventable infections, and eliminate serious medical errors,” said Donald Berwick, administrator of the Centers for Medicare and Medicaid Services. “As we reduce the frequency of these conditions, we will improve care for patients and bring down costs at the same time.”

Big medical associations are concerned about the new rule. As a result, CMS is allowing states until July 2012 to implement the new policy and increase nonpayment to different types of health care facilities beyond the hospital setting and create their own “Never Events”. CMS wants to foster better coordination between nursing facilities and hospitals and gain better health outcomes in tandem with the current administration’s Partnership for Patients initiative.

Proponents of the new rule say that patients at long-term care, rehab, and outpatient facilities will benefit in time as states expand the ruling to these health care centers, and not just keep it hospital or nursing home focused. “Never Events” such as Stage III and IV pressure ulcers and
deep vein thrombosis (DVT) or a pulmonary embolism (PE) after a total knee replacement or hip replacement will no longer be covered, barring pediatric or obstetric exceptions.1

To prevent these types of “Never Events” health care professionals can contact an experienced compression therapy distributor to meet their patient’s needs. Vascular PRN is skilled in helping hospitals, nursing homes, surgery centers and other institutions get the best equipment at a great value. The company carries the top name brands for rent and for sale, and delivers nationwide. For DVT, they have a wide selection of foot, calf, and leg pumps and bariatric solutions too. For the prevention of pressure ulcers, they carry the new Skin IQ™ Microclimate Manager waterproof mattress cover to maintain a patient’s skin integrity and decrease nosocomial risk when used early on as part of the patient’s therapy on an existing pressure redistribution mattress. To learn more, visit www.vascularprn.com or call 800-886-4331.

Vascular PRN
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Tampa, FL 33619
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800-886-4331