Anthem Blue Cross No Longer Reimbursing Major Preventable Events, Including HAIs
Anthem Blue Cross Announces Initiative Aimed at Preventing Serious Medical Errors; Company Committed to Protecting Members' Health and Finances by Not Reimbursing Major Preventable Adverse Events
WOODLAND HILLS, Calif., April 2, 2008 /PRNewswire/ -- Anthem Blue Cross announced today process changes for its hospital network to be implemented this year. The changes will include reimbursement modifications and are aimed at eliminating preventable adverse events as defined by the Centers for Medicare and Medicaid Services (CMS) and the National Quality Forum. They will help protect Anthem Blue Cross's eight million members from additional payments resulting from these errors."
Anthem's primary focus will be to ensure that physicians and hospitals are using appropriate processes, technologies and strategies to address 'never events' and, ultimately, to enhance the quality of care delivered to hospitalized patients," said Dr. Zeinab Dabbah, Chief Medical Officer of Anthem Blue Cross. "We will continue to work collaboratively with physicians and hospitals to analyze why and how these events occur, and to proactively find ways to improve patient safety and clinical care."
Anthem's first phase of the initiative includes 11 preventable adverse events and will be modified and expanded in the future. Anthem recently communicated to its network hospitals about its policy intended to ensure that no one will be charged if any of the following three events occur:
-- Surgery performed on the wrong body part; -- Surgery performed on the wrong patient; and -- Wrong surgery performed on a patient.
In addition, Anthem's changes will help ensure that only the appropriate payment is made and no additional charges are incurred if any of these events occur:
-- Object left in the body during surgery; -- Air embolism or blockage; -- Blood incompatibility; -- Catheter-associated urinary tract infection; -- Decubitus (pressure) ulcers; -- Vascular catheter-associated infection; -- Mediastinitis (an infection inside the chest) after coronary artery bypass graft (CABG) surgery; and -- Hospital-acquired injuries such as fractures, dislocations, intracranial injuries, crushing injuries and burns.
"We are listening to our members, business coalitions, and our key accounts who want to know their health plan is looking out for them," said Leslie Margolin, president of Anthem Blue Cross. "As a strong advocate for patient safety, Anthem firmly believes that putting processes in place that focus on preventing these events can have an immediate impact on health care safety and quality."
WOODLAND HILLS, Calif., April 2, 2008 /PRNewswire/ -- Anthem Blue Cross announced today process changes for its hospital network to be implemented this year. The changes will include reimbursement modifications and are aimed at eliminating preventable adverse events as defined by the Centers for Medicare and Medicaid Services (CMS) and the National Quality Forum. They will help protect Anthem Blue Cross's eight million members from additional payments resulting from these errors."
Anthem's primary focus will be to ensure that physicians and hospitals are using appropriate processes, technologies and strategies to address 'never events' and, ultimately, to enhance the quality of care delivered to hospitalized patients," said Dr. Zeinab Dabbah, Chief Medical Officer of Anthem Blue Cross. "We will continue to work collaboratively with physicians and hospitals to analyze why and how these events occur, and to proactively find ways to improve patient safety and clinical care."
Anthem's first phase of the initiative includes 11 preventable adverse events and will be modified and expanded in the future. Anthem recently communicated to its network hospitals about its policy intended to ensure that no one will be charged if any of the following three events occur:
-- Surgery performed on the wrong body part; -- Surgery performed on the wrong patient; and -- Wrong surgery performed on a patient.
In addition, Anthem's changes will help ensure that only the appropriate payment is made and no additional charges are incurred if any of these events occur:
-- Object left in the body during surgery; -- Air embolism or blockage; -- Blood incompatibility; -- Catheter-associated urinary tract infection; -- Decubitus (pressure) ulcers; -- Vascular catheter-associated infection; -- Mediastinitis (an infection inside the chest) after coronary artery bypass graft (CABG) surgery; and -- Hospital-acquired injuries such as fractures, dislocations, intracranial injuries, crushing injuries and burns.
"We are listening to our members, business coalitions, and our key accounts who want to know their health plan is looking out for them," said Leslie Margolin, president of Anthem Blue Cross. "As a strong advocate for patient safety, Anthem firmly believes that putting processes in place that focus on preventing these events can have an immediate impact on health care safety and quality."
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