Addressing More Than Just the Error
I read the column "No Shame in Blame (Sometimes)" in the February 2008 issue. My mother died four years ago from an accidental potassium overdose while hospitalized, and my family has supported and assisted the hospital in building a blame-free culture.
We strongly believed that her death was the result of a process breakdown, and we were active in making suggestions on how to improve the process. Our suggestions went further than just addressing the drug error--we addressed other issues that included the way family members are treated in the ICU. It didn't hurt that I was a nurse before I was a doctor and that the facility was one of my training institutions and that many of the people involved in the error were people I had worked with. We continue to support their efforts in building that blame-free culture but would love to see faster process improvements.
To not have an answer as to why someone died can be more painful than knowing the method of their death. The why they died takes longer to deal with.
Maureen L. Prowse, MD
Palm Desert, CA
Editor's Note: The following letter is in response to the online column, "Welcome to 2008! We're in Debt Up to Our Eyeballs!" (HealthLeaders Media Finance, Jan. 7, 2008), in which Finance Editor Philip Betbeze discusses how the federal government's inability to fund its commitments may filter down to hospitals and physician practices. To read the column, click here.
Getting What You're Owed
Your article appropriately draws attention to the monstrous gorilla sitting in the room that no one--neither our elected nor our wanna-get-elected officials--seems to want to talk about. As Medicare and Medicaid dollars continue to shrink when factored into the increasing cost of providing healthcare and unreimbursed healthcare costs, hospitals and healthcare providers must do a better job at securing what they are owed from payers. As the prospects continue to grow dim for healthcare providers securing any meaningful payment increases from our debt-ridden government through Medicare and Medicaid and securing little or any reimbursement from an increasingly uninsured (and under-insured) population, healthcare providers are faced with few options.
On the whole, the HMO/payer industry is light years ahead of healthcare providers in the battle of managed care contracting and managing (limiting) reimbursement. To a certain extent, providers' dependence on government reimbursement (and periodical Medicare/Medicaid increases) has contributed to this problem. Our company has identified and recovered as much as $18 million from payers for one hospital--and this from patient accounts the hospital felt were paid correctly.
If health systems, hospitals and providers were to secure most or all of the payments they're due from commercial payers, many negative aspects of the "healthcare crisis" could be eliminated . or at least diminished.
PPO Check, Ltd.