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HealthPartners hospital payment policy
On Jan. 1, 2005, HealthPartners implemented a policy that witholds payment to hospitals for extremely rare medical errors identified by the National Quality Forum as things that should never happen to a patient. These events, called "never events" include errors such as surgery performed on the wrong body part or on the wrong patient, or leaving a foreign object in a patient after surgery. We believe that patients should never pay for "never events."
The Minnesota Hospital Association and its member hospitals have been leaders in advancing patient safety in Minnesota. They led the way in establishing pioneering legislation on "never events." The new policy builds on that legislation by stopping payment to a hospital and does not affect individual physicians.
We applaud the hospitals that already waive costs associated with never events and will continue to work with our hospital partners to ensure that this is the case for every patient, every time.
Learn more about "never events":
Read a statement on "never events" by our medical director
Answers to Frequently Asked Questions
What are "never events"?
The National Quality Forum, a nonprofit national coalition of physicians, hospitals, businesses and policy-makers, has identified 27 events as occurrences that should never happen in a hospital and can be prevented. They include surgical events such as performing the wrong surgical procedure, product or device events such as contaminated drugs or devices and criminal events such as abduction of a patient.
See
a complete list of "never events."
More information can be found on the NQF Web site.
What is HealthPartners policy?
On Jan. 1, 2005, HealthPartners implemented a policy that stops payment to hospitals for "never events". The policy states that:
- HealthPartners will not pay for services associated with a never event or permit providers to bill members.
- If a provider bills HealthPartners or a member, the provider must notify HealthPartners.
Read HealthPartners
policy.
Is this a cost savings measure?
No. These events are rare and thus do not represent a significant savings for the health plan. For a patient, it could relieve a financial burden; especially for members who have deductibles and copayments. We believe that any patient who suffers from a "never event" should never have to pay for it.
This policy reinforces patient safety initiatives underway at Minnesota hospitals by aligning the payment system to match those efforts. HealthPartners pay-for-performance program this year will award $16 million to physicians for delivering the highest quality care.
If HealthPartners denies a claim, will patients end up paying?
No. We want to make sure that patients never pay for never events. We applaud hospitals that don't currently bill patients for "never events." This policy is an extension of that practice and will help ensure that patients aren't billed for "never events."
How often do "never events" occur?
The Minnesota Department of Health
released a report
on "never events" on Jan. 19, 2005.
Do hospitals already waive charges related to "never events?"
Some hospitals already waive charges related to "never events." The Minnesota Hospital Association and its member hospitals deserve credit for leadership in advancing safety initiatives in Minnesota. They lead the way in sponsoring the "never events" legislation. It is through a partnership with hospitals that we can ensure that patients in Minnesota experience the safest care in the country.
Won't this lead HealthPartners to not pay for other medical errors?
This policy applies to hospitals only and is limited to 27 "never events." It is based on state law that is supported by Minnesota hospitals and it reflects standards established by a national coalition on heath care quality. HealthPartners policies will continue to be consistent with state and national quality standards.
Contacts:
Patricia Lund 952-883-5308
pager: 612-527-1921
patricia.a.lund@healthpartners.com
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