How Hospitals Get Away with Billing Medicare for Preventable Complications

The idea seems so simple:

  • (A) When hospitals leave catheters in people’s bladders for too long, people get urinary infections.
  • (B)  Third party payers like Medicare and insurance companies are then billed for the cost of treating these infections.
  • (C)  If Medicare refuses to pay for these treatments, and force hospitals to bear the cost of their substandard care, then either:
    1. Hospitals will improve the quality of their care or
    2. Medicare spending will go down, because it won’t be forced to pay for hospitals’ mistakes.

This simple idea has been out there in one form or another for a little while now. And I’m sorry to say that, at least so far, it seems to have failed miserably. But in this failure are some important lessons for just how difficult it is to design health care reimbursement systems that incentivize hospitals… (Read more and view comments at Forbes)

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