How Medicare Reimbursement Changes Affect Biomeds

Effective October 1, 2008 Medicare will no longer reimburse medical facilities for eight conditions that patients can acquire while being a patient at a medical facilty. These conditions known as “Hospital-Acquired Infections or HAIs and consist of the following conditions:

Bed Sores
Objects Left In A Patient After Surgery
In-Hospital Falls
Blood Incompatibility
Mediastinitis - inflammation of the tissues in the mid-chest.
Air Embolism
Catheter-Associated Urinary Tract Infections
Central Venous Catheter-Related Bloodstream Infections

HAIs are estimated to affect two million patients a year and kill approximately 100,000 annually. HAIs cost around $25,000.00 per infection/incident to treat or about $4.5 Billion annually.

So how does all this affect us Biomeds?

While I don’t know how we can help stop blood incompatibility, catheter related infections, air embolisms, and Mediastinitis, I do know that our expertise can be used to help our facilities stop and limit Bed Sores, Patient Falls, and Objects Left In Patients.

As Biomeds our jobs aren’t limited to Testing and Repairing Equipment. A major aspect of our profession is staying on the cutting edge of new technology offerings and knowing how to implement it in our facilities to generate profits/revenues, limit expenditures, limit liability and most importantly to promote patient safety.

So here is how the new Medicare Changes affect us and what we can do about it.

BED SORES: Are generally caused by patient immobility (not moving).
1. Most if not all bed manufacturers now offer patient beds with smart mattress technology that helps against the development of bed sores. For those of us that work in facilities that haven’t upgraded to the newer beds, here is a great justification for them.
2. Institute a Cable and Tube management system that will allow nurses rotate patient position easily. Nurses may find it difficult to rotate a patient with all the cables and tubes in the way, and therefor may push off doing it.
PATIENT FALLS: Patients Falling out of beds, stretchers, wheel chairs, etc.
1. Make sure that Bed Guard Rails are working properly and the staff knows how to correctly use them.
2. Institute a Bed Alarm that will alarm if a patient starts falling off or has fallen off a bed.
OBJECTS LEFT IN PATIENTS: During Surgical procedures items such as instruments, devices, etc. can be left inside a patient by accident.
1. Institute a policy where all patients who have undergone a surgical procedure be X-ray’d or otherwise imaged to ensure that no item has been left inside either prior to closing or right after closing. There are many technologies out there that can take a quick image to ensure that there isn’t something where it shouldn’t be.

I am sure that there are many other ways we can help our facilities and clients meet the challenges presented by the new Medicare Reimbursement Changes.

What ideas do you have? What have you done? Share with a comment!

Sources: Ultimate Nurse Blog, US CMS