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Anthem Blue Cross and Blue Shield in Wisconsin Announces Initiative Aimed at Preventing Serious Medical Errors; Company Committed to Protecting Members' Health and Finances by Not Reimbursing Major Preventable Adverse Events
Date:4/2/2008

MILWAUKEE, April 2, 2008 /PRNewswire/ -- Anthem Blue Cross and Blue Shield in Wisconsin 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. These reimbursement modifications will help protect Anthem's nearly 1 million members from additional payments resulting from these "never events."

"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 Michael Jaeger, M.D., medical director for Anthem Blue Cross and Blue Shield in Wisconsin. "We will continue to work collaboratively with physicians and hospitals to analyze why and how these events have occurred, and to proactively find ways to improve patient safety and clinical care."

Anthem's first phase of the initiative will preclude reimbursement to providers who have performed any of 11 preventable adverse events selected by Anthem from the broader list developed by CMS and the National Quality Forum. The list of preventable events that, if performed erroneously on Anthem members, will not be reimbursed will be expanded in the future. Anthem recently communicated to its network hospitals that its policy is 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;


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SOURCE Anthem Blue Cross and Blue Shield in Wisconsin
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