Botched health care costing government

WASHINGTON (AP) -- The government could save hundreds of millions of dollars a year if the Medicare program would stop paying for medical errors such as operations on the wrong body part or mismatched blood transfusions.

Mark McClellan, who directs the Medicare and Medicaid programs, said Wednesday the government reimburses doctors, hospitals and other health care providers even when they make serious and preventable errors. The government pays them for the type of service performed rather than the quality.

"If you talk to health professionals, they will tell you these events should never happen, but then, if you look at Medicare's payment systems, we actually pay for all these events," McClellan said after a Senate hearing. "We pay more in many cases."

He said it is hard to say exactly how often the government pays for botched health care. He also was sketchy on when the government could stop paying for medical errors, saying he would like to move aggressively and wants Congress to help.

"There are several numbers out there, but these events happen daily," he said. "The (savings) could be in the hundreds of millions of dollars a year."

Already, Medicare has changed the way it makes payments. He said Congress gave the Centers for Medicare and Medicaid Services the power to cut payments when infections occur during a hospital stay. These reductions can begin in 2008.

McClellan testified at a Senate Finance Committee hearing on specialty hospitals, in which physicians who work in them have an ownership stake. Some lawmakers say such ownership represents a conflict of interest.

In testimony about regulation of specialty hospitals, McClellan said payments should be based on the premise of supporting higher quality.

He said the National Quality Forum, a nonprofit group that develops ways to improve health care, has identified 27 types of preventable errors that could result in lower reimbursements.

Some states now require that doctors, hospitals and other providers report when a patient suffers from one of those 27 errors.

Minnesota, for example, said recently in its second annual report on "never events" that providers reported 106 serious and preventable errors for the 12-month period that ended in October. Those events led to 12 deaths and nine people being seriously disabled, according to the report.

Half of the errors involved surgery in which surgery was done on the wrong body part (16 events), the wrong patient (two), the wrong procedure (eight), or a foreign object was mistakenly implanted (16). There were no deaths in any of the 52 cases.

Another error was the development of serious pressure ulcers after admission (31).

About 43 million elderly and disabled people participate in Medicare. The budget for the program, including payments to hospitals, doctors, and prescription drug plans, is projected to be $340 billion this year.