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."
Anthem Blue Cross is in the early stages of implementation. This allows the company to work alongside hospitals to address the preventability of these events as soon as possible and continue to monitor the activities related to the list of events from the federal, state and private payers, and make adjustments as necessary and appropriate.
Anthem Blue Cross has long been committed to promoting patient safety
-- Inclusion of patient safety metrics in Anthem Blue Cross's Quality-in-
Sights Hospital Incentive Program as well as the Member Health Index
(MHI) program, the first program in the industry to track and compare
the collective health of all health plan members based on 20 clinical
areas and 40 separate component measures;
-- Support of the Institute for Healthcare Improvement's (IHI) 5 Million
Lives campaign, a voluntary initiative to protect patients from five
million incidents of medical harm through December 2008; and
-- Participation in Leapfrog's patient safety survey to reduce preventable
medical mistakes and improve the quality and affordability of health
"Anthem Blue Cross's efforts to concentrate on patient safety and work toward eliminating avoidable hospital errors are commendable and commensurate with our goals for a safer health care system that must realign itself to pay on the basis of safety and quality," said Diane Pinakiewicz, president of the National Patient Safety Foundation. "It is important that our industry find ways to correct the systems issues that allow avoidable errors to occur, and Anthem Blue Cross's leadership in the field will help move us in this direction."
About Anthem Blue Cross:
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. (R) ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross names and symbols are registered marks of the Blue Cross Association.
|SOURCE Anthem Blue Cross|
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