Navigation Links
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;

-- 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 Dr. Jaeger. "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 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 has long been committed to promoting patient safety including:

-- Inclusion of patient safety metrics in Anthem's 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 care.

"The Wisconsin Hospital Association (WHA) is pleased that Anthem Blue Cross and Blue Shield in Wisconsin is focusing on serious adverse events. WHA has a long track record in working to improve quality and patient safety, and we firmly believe that it is these improvement efforts that will lead to the elimination of serious adverse events," said Steve Brenton, President and CEO of the Wisconsin Hospital Association. "We look forward to collaborating with Anthem in this important effort."

In Wisconsin, Anthem Blue Cross and Blue Shield is the trade name used by Blue Cross Blue Shield of Wisconsin ("BCBSWi") and Compcare Health Services Insurance Corporation ("Compcare"), independent licensees of the Blue Cross and Blue Shield Association. (R)ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Wisconsin is available at http://www.anthem.com.


'/>"/>
SOURCE Anthem Blue Cross and Blue Shield in Wisconsin
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. Anthem Sponsors Healthy Kids Day at Maines YMCAs
2. Anthem Blue Cross and Blue Shield Foundation Donates $7,500 to San Luis Valley American Red Cross to Assist Residents Affected by Water Contamination Crisis
3. Anthem Blue Cross and Blue Shield Acts to Support Las Vegans Impacted by Endoscopy Center Practices
4. Anthem National Accounts Introduces New Products for Large Employers Early Retirees
5. Anthem Blue Cross and Blue Shields Promoting Healthcare Quality Program Improves Quality and Patient Safety in 19 Colorado Hospitals
6. Anthem Blue Cross and Blue Shields Member Health Index Named BlueWorks(R) Award Winner
7. Anthem Blue Cross and Blue Shield Teams with the State of Indiana to Combat Obesity
8. Anthem Blue Cross and Blue Shield Expands Network of Hospitals to Serve Hoosier Healthwise Members
9. WellPoint Announces Appointment of John Langenus as President of Anthem National Accounts
10. Anthem Blue Cross and Blue Shield Celebrates Local Moms-to-Be at Community Baby Shower
11. Anthem Blue Cross and Blue Shield Foundation and Plan Associates Pledge $2.2 Million to Community Organizations in 2008
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/27/2016)... ... 27, 2016 , ... An educational campaign aimed at everyone ... courtesy of awareness-driven celebrities and thought leaders. It also provides insight to the ... leaders such as Bioness. , As patients feel increasingly concerned about the ...
(Date:5/27/2016)... ... May 27, 2016 , ... Beleza Medspa has initiated ... regulations. This is the first time that Coolsculpting is being used for for ... six months to ensure they meet the prescribed body-fat standard, measured by the circumference-based ...
(Date:5/27/2016)... ... May 27, 2016 , ... Aimed at nurses and ... stories, which come courtesy of leaders in the nursing and health care industry. It ... advocates and associations—namely Abilene Christian University. , As the nursing industry is coming ...
(Date:5/27/2016)... (PRWEB) , ... May 27, 2016 , ... ... trusted name in the pharmaceutical, medical and food industries. Aside from its GMP ... certification (SIC), providing proof of successfully certified products, services and staff. , Validation ...
(Date:5/26/2016)... ... May 26, 2016 , ... There are many ways ... and Sausage Council (NHDSC) suggests that Americans prefer their dogs straight off the grill. ... say grilling is their favorite way to cook a hot dog, far outpacing other ...
Breaking Medicine News(10 mins):
(Date:5/27/2016)... Kitov Pharmaceuticals ... late-stage drug development, today announced the completion of ... batches required for registration of KIT-302 with the ... Kitov,s announcement in December 2015, that ... primary efficacy endpoint. "We are fortunate ...
(Date:5/26/2016)... May 26, 2016 A key ... is the emergence of new treatments. Cardax, a development ... osteoarthritis treatment. The therapy is expected to fulfil large ... UK is conducting studies to develop new treatments for ... the genes involved in osteoarthritis are being investigated, and ...
(Date:5/25/2016)... FDA 510(k) clearance covers Confocal Miniprobes ... and surgical applications Mauna Kea Technologies ... multidisciplinary confocal laser endomicroscopy (CLE) platform, today announced ... the 12 th 510(k) clearance from United ... FDA clearance covers Confocal Miniprobes indicated for use ...
Breaking Medicine Technology: