Beginning this fall, the federal government will not pay hospitals for the treatment of a variety of preventable errors, injuries and infections suffered by Medicare patients. Pennsylvania followed last week with a new policy to no longer make Medicaid payments to hospitals to treat preventable errors in 27 areas. Maine lawmakers will soon consider going even further by prohibiting hospitals from billing patients or their insurance providers for treatment of preventable errors. This approach is worth a close look, especially as the Maine Hospital Association has pledged to voluntarily move in this direction.

The Bush administration estimates the new rules from the Centers for Medicare & Medicaid Services (CMS) will save $20 million a year, by stopping payments to hospitals for injuries caused by falls, leaving objects in patients during surgery, using incompatible blood and five other errors deemed preventable. Health care experts expect the savings to be substantially higher.

Three types of infections are included in the CMS list and have received much scrutiny. According to the Centers for Disease Control and Prevention, 1.7 million patients develop infections in hospitals each year, contributing to the death of 99,000 people a year. They also drive up medical costs.

A study, published in a recent issue of the Journal of the American Medical Association, looked at the cost of catheter-associated urinary tract infections, which Medicare will stop reimbursement for in October. According to the study, treatment of a patient with a heart attack without complications at the University of Colorado Hospital would result in a Medicare reimbursement of about $5,444. Care for the identical patient with a complicating urinary tract infection would result in a $6,721 reimbursement. If the same patient had a long-term catheter that resulted in an E. coli infection, the reimbursement would rise to $8,905, resulting in “perverse financial incentives,” the study said.

Michigan hospitals have dramatically reduced infection rates associated with catheters, not with new technology but by ensuring patients and doctors are covered with sterile gown when catheters are inserted, the New York Times reported last year. Hospital executives said such practices saved 1,700 lives and $246 million since 2002, according to the newspaper.

Not all of the eight conditions covered by the CMS order lend themselves to such easy fixes, but Michigan’s experience shows that simple steps can markedly improve outcomes. Still, concerns that doctors and hospitals will do more tests when patients are admitted to document pre-existing conditions is a valid concern that must be addressed.

As Dr. Erik Steele wrote on these pages earlier this month: “The door is opening on a new way to deal with errors in patient care, and slowly but surely the fresh, clean air of truth is coming to the relationship between patients and caregivers who unintentionally cause them harm. Telling the patient or patient’s family the truth about a harmful error in the patient’s care has become the new standard of care.”

Admitting a mistake is a large first step. Not charging for it, seems like a logical next move. LD 2044 and the hospital association announcement give lawmakers the opportunity to consider moving Maine further down that path.