BOSTON - The Massachusetts Hospital Association said Tuesday that its members will no longer charge patients or insurers for treatments rendered to address preventable errors that occur within a hospital. With this announcement, the Bay State joins Minnesota as the only two states that have voluntarily taken the "no charge" pledge.
In August, Medicare announced that beginning in October 2008, it would no longer pay for treatment related to eight kinds of adverse events that occur in hospitals. The rules also prevent hospitals from passing the costs on to patients. But Massachusetts hopes to establish itself as a leader in transparency and quality by beating Medicare to the punch and enacting a similar policy in early 2008.
"Over the next six weeks, we'll be working with Massachusetts insurers, patient advocates and the hospitals themselves on an implementation plan," said MHA Director of Communications Rich Copp.
The policy will apply to any of the nine National Quality Forum-defined events and any subsequent care needed to manage the event. Such events include wrong site surgery and medication errors. The hospital community will work collaboratively with an advisory group comprised of hospital members from both clinical and financial departments, the physician community, the health insurance companies, and patient-consumer representatives to implement the plan.
"This is just to codify what many of our hospitals are already doing in practice," Copp said. "These are extremely rare events, and hospitals routinely report when these events happen, and disclose the error and apologize to the patients."
The nine NQF-defined events include:
•Surgery on wrong body part
•Surgery on wrong patient
•Wrong surgical procedure
•Unintended retention of a foreign object
•Patient death or serious disability associated with air embolism that occurs while being treated in a health care facility
•Patient death or serious disability associated with a medication error
•Patient death or serious disability associated with a hemolytic reaction due to administration of incompatible blood or blood products
•Artificial insemination with the wrong donor sperm or wrong egg
•Infant discharged to the wrong family.
Copp said the MHA intends to start with this list and as hospitals gain experience in implementing the policy, the list will be expanded to include other certain events as defined by national standards.
It's clear from the MHA's announcement that various stakeholders have already played a role in the policy.
In a prepared statement, Marylou Buyse, MD, a practicing primary care physician and president of the Massachusetts Association of Health Plans, said, "This represents an important step forward for the entire health care community. We applaud this effort and look forward to working with hospitals to put it into place."
"The leadership demonstrated in this action signals strongly the energy and resolve our state's healthcare executives are bringing to advancing the quality and safety of care in Massachusetts," added James Conway, Senior Vice President, Institute for Healthcare Improvement. "It also establishes a model of accountability for other states and provider groups around the nation to learn from and emulate."
Minnesota became the first state to enact the policy in September. It announced a plan that would not charge for treatment in the case of 27 different adverse events, as defined by a 2004 state law. According to news reports, Minnesota reported 154 such incidents in 2006, while providing 8 million inpatient visits.