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CMS “Never Events” Incentivize Physicians To Avoid Caring For High Risk Patients

March 27th, 2011 by DrRich in Health Policy, Opinion
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In 2008, the Centers for Medicare and Medicaid Services (CMS) announced it would no longer pay for the treatment of “never events,” i.e., certain medical conditions in hospitalized patients which the Feds deem to be universally avoidable under all circumstances. These conditions included:

* Decubitus ulcers
* Two kinds of catheter-associated infections
* Air embolism
* Mediastinitis after coronary bypass surgery
* Transfusing patients with the wrong blood type
* Leaving objects inside surgery patients
* In-hospital falls

Then, having been delighted with the results of its original list (or dismayed that healthcare costs continued to skyrocket despite its original list) CMS subsequently proposed declaring several new conditions as “never events,” including: Read more »

*This blog post was originally published at The Covert Rationing Blog*

Fear And The High Risk Patient

March 19th, 2011 by DrWes in Opinion, True Stories
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Every day, doctors do risky things for their patients, often because they have no other options. Today is such a day for me.

I don’t know how it will go, and because of privacy laws I really can’t tell you about the case, I’m sorry. (Nor will you get an epilogue, that’s not the point of this post). But let’s just say that any normal person would consider the case I’m about to perform very high risk because of the patient’s condition. Even though you tell people they could die and take care to mention that fact time and time again, you wonder if they really can comprehend the significance of what you’re saying – after all, there is a fine line between being reassuring in a time of crisis and telling it like it is. Read more »

*This blog post was originally published at Dr. Wes*