NCPA - National Center for Policy Analysis


August 20, 2007

The Bush administration, in another step toward linking pay to performance in Medicare, will stop compensating hospitals for treating certain "reasonably preventable" conditions acquired there, says the Wall Street Journal.

  • The eight conditions include injuries from patient falls, pressure ulcers, urinary-tract infections, vascular-catheter-associated infections and mediastinitis, an infection following heart surgery.
  • Also included are so-called never events, meaning they never should happen: objects left in the body during surgery, air embolisms and blood incompatibility.

The rule change, mandated by a 2005 law and proposed in April, takes effect in October 2008.  Medicare said it will add three additional conditions next year.

The effort "underscores the continued, steady CMS drive to become an active purchaser, not passive payer, of health care," said Jeff Nelligan, spokesman for the federal Centers for Medicare and Medicaid Services, the agency that manages Medicare, which covers health care for elderly and disabled Americans.

The change comes as the government is increasingly concerned about the rising cost of Medicare, which totaled $408 billion in 2006, amid an aging population:

  • As a result, the government is trying to hold health-care providers more accountable for quality.
  • Since October 2006, hospitals have been required to report certain quality data or face a penalty; beginning in October, Medicare will increase the number of quality measurements to 27.

Source: Jane Zhang, "Medicare to Stop Paying For Some Hospital Errors," Wall Street Journal, August 20, 2007.

For text:


Browse more articles on Health Issues