Recently-passed laws in several states, including Maryland, Virginia, and Washington, D.C., require hospitals to detail serious injuries; this reveals the frequency and variety of so-called “never events” which should never happen. The laws are different in each state. Virginia’s public records identify the hospitals by name, but Maryland and Washington, D.C.’s don’t name names.
Five years ago, a Maryland law was passed requiring Maryland hospitals to report errors that led to death and serious harm. This month, the Maryland commission that sets hospital rates is using a new system that ranks hospitals on how often they commit 52 specific mistakes, from preventable obstetrical complications to infections of wounds that develop after surgery. Maryland hospitals that report the most mistakes from that list will be required to bill insurers at a lower reimbursement rate. In other words, good hospitals will make more money.
I think most Maryland malpractice hospital lawyers support this idea. The better hospitals get more money, which motivates them to get better. I worry, though, about any hospital that is last on this list. No real motive for the hospital to get better because they are too far from the higher reimbursement. But the rich Maryland hospitals get richer while the poor hospitals get poorer with no motivation to get better.
Again, I like the idea but there is a potential downside.