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To err is human... but it’ll cost you

Ambulatory Safety Monitor, October 14, 2004

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Surgeons in Minnesota are about to receive greater incentive than ever to ensure that the procedures they perform go off without a hitch. Starting on January 1, 2005, major health insurer HealthPartners will no longer cover medical procedures during which adverse events occur.

The decision-which would assess physicians for out-of-pocket expenses in conjunction with medical mistakes like surgery performed on the wrong side of the patient's body or a foreign object being left inside the patient-is the first effort in Minnesota to penalize surgeons for incompetent care. The new policy represents a flipside to the growing wave of "pay-for-performance" financial incentives being offered to doctors across the country for providing high-quality care.

"It's about accountability," Dr. George Isham, medical director for HealthPartners, told the Associated Press. "We're sending the message that things that shouldn't happen shouldn't be paid for."

HealthPartners, the state's third-largest insurer behind Blue Cross/Blue Shield and Medica, has said that the types of errors that the company will no longer pay for happen so infrequently that they don't expect a significant cost savings. Since July of 2003, when healthcare providers in Minnesota became required to report adverse events, there were a total of 40 events reported from hospitals that contract with HealthPartners.

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