NY Medicaid will stop paying for 'never events'

Wed, 11 Jun 2008 06:59:57 -0400

New York's Medicaid program has decided to stop reimbursing for avoidable hospital complications and medical errors it considers to be "never events." Starting in October, it won't pay for care related to 14 conditions, including wrong-site surgery; foreign objects left in the body; medication errors; blood incompatibility; contaminated drugs and patient disability from electric shock. Hospitals that want to receive Medicaid payments will have to prove that such conditions were present on admission to get paid for treating them. Meanwhile, the state expects to keep expanding this list.

To learn more about New York's decision:
- read this Modern Healthcare report (reg. req.)

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Study: OR Medicaid cuts push up ED visits

Wed, 23 Apr 2008 06:59:56 -0400

A new study suggests that at least in Oregon, Medicaid may be helping providers avoid costly emergency department visits by the uninsured. The study, which appears in this month's Annals of Emergency Medicine, found that ED visits by the state's uninsured saw an "abrupt and sustained" climb when it cut more than 50,000 beneficiaries from the Medicaid program. The researchers, who looked at hospital billing data on more than 2.5 million visits to 26 Oregon EDs, looked at data two years after the Medicaid program underwent the cuts. After Medicaid dropped the beneficiaries, ED visits went up noticeably, from 6,682 per month in 2002 to 9,058 per month in 2004.

To learn more about the study:
- read this Annals of Emergency Medicine article (.pdf)
- read this HFMA News item

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