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Medicare Never Pay Events Essay

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Medicare is currently the primary healthcare insurer of the elderly in the United States of America. Medicare, which is funded by the federal government, paid providers $444 billion dollars in 2008 for healthcare expenses (National Healthcare and Medicare Spending, 2010). Due to enormous expenses, Medicare implemented changes during 2008 to improve patient safety and reduce cost by eliminating reimbursement to those who provide unsafe care.

Medicare designed a list of “never” events. These are events Medicare will not reimburse, and the provider cannot bill the patient for the service.

All providers receiving Medicare reimbursement have made themselves very familiar with the list outlined by Medicare. Failure to adhere to the list of never events would lead a facility into bankruptcy and out of business. The list includes wrong site surgery, retention of foreign object, death or disability with intravascular air embolism while in a healthcare facility, infant discharged to wrong person, patient death or disability associated with patient disappearance for more than four hours, patient suicide or attempted suicide resulting in serious disability while being cared for in a healthcare facility, death or disability due to medication error, death or disability due to incompatible blood products, death or disability associated with hypoglycemia while being cared for in a healthcare facility, stage three or four pressure ulcers acquired after admission to a healthcare facility, and sexual assault while on the grounds of a healthcare facility (Torrey, 2011).

Basically, never events are incidents that should never happen to anyone, and if they do neither Medicare nor the patient will be financially responsible. Thus, increasing accountability to the providing facility.

Medicare Reimbursement and Nurse Retention

Medicare reimbursement affects nurse retention by reducing revenue that could be allocated into budgets for pay increases, benefits, supplies, continuing education, and recruitment. In addition, keep in mind the stress associated with staff being aware of the costly event and the injury sustained by the individual and family. Furthermore, many of these issues are sure to stimulate legal action. Decreased budgets and additional stress factors definitely decrease nurses longevity with a facility.

References
Torrey, T., (2011). What is a medical error? Retrieved from: http://patients.about.com/od/atthehospital/a/mederrorlist.htm National healthcare and Medicare spending. (2010). Retrieved from: http://www.medpac.gov/chapters/Jun10DataBookSec1.pdf

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