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09-28-2007, 03:42 PM
The Wall Street Journal on Wednesday examined how hospitals across the U.S. "are scrambling to put new programs in place to prevent pressure ulcers," or bedsores, after CMS (http://www.cms.hhs.gov/) last month announced (http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=3&DR_ID=46979) that starting in October 2008 it no longer will provide reimbursements for eight preventable medical errors. In 2006, there were 322,946 reported cases of pressure ulcers as a "secondary diagnosis" in hospitalized Medicare beneficiaries. Treating severe ulcers that require surgery can cost up to $70,000, according to studies.

According to the Journal, health care experts "agree that bedsores are a classic example of preventable harm: Despite strong evidence of effective strategies for prevention, guidelines are frequently ignored or overlooked." The Journal reports that "[p]art of the problem is a nationwide nursing shortage that makes for a more harried and chaotic hospital environment," but there also has "been no real incentive for prevention programs."

CMS officials say the new payment policy will provide strong incentive for hospitals to screen patients who might be at risk for developing pressure ulcers. Hospitals can receive reimbursement for treatment if they can document that the ulcer was present when the beneficiary was admitted. Critics of the rules say that unreimbursed costs for treatment will lead to higher medical charges for all patients.

To prevent ulcers, "hospitals are pushing screenings of all incoming patients from head to toe for skin issues that could lead to pressure ulcers" using visual examinations, ultrasound and other technologies, the Journal reports. In addition, a number of quality groups are working with hospitals to implement new prevention programs "using lessons learned" from hospitals that have "sharply reduced or even eliminated pressure ulcers," according to the Journal (Landro, Wall Street Journal, 9/5).

Reprinted with kind permission from http://www.kaisernetwork.org (http://www.kaisernetwork.org/). You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy (http://www.kaisernetwork.org/dailyreports/healthpolicy). The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family FoundationŠ 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.