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Thursday, April 3, 2008

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Wellpoint targets botched surgeries

doctors perform surgery

The health insurance company Wellpoint has announced a new strategy for discouraging medical errors. It says it will no longer reimburse hospitals for botched operations. Ashley Milne-Tyte reports.

Doctors doing heart surgery in operating room (Bob Riha, Jr./Childrens Hospital Los Angeles via Getty Images)

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Scott Jagow: The health insurance company Wellpoint has announced its new strategy for discouraging medical errors. It says it will no longer reimburse hospitals for botched operations. Ashley Milne-Tyte reports.


Ashley Milne-Tyte The medical community refers to big mistakes as "never events" -- things hospital staff hope will never happen. Sam Nussbaum is chief medical officer for Wellpoint.

Sam Nussbaum: We will not be paying for surgery performed on the wrong body part, surgery performed on the wrong patient, nor the wrong surgery performed on a patient.

Later this year, Wellpoint plans to stop reimbursement for other things, such as hospital-acquired infections. Nussbaum says WellPoint wants hospitals to invest in better strategies to prevent errors. Atul Gawande is a surgeon at Brigham and Women's hospital in Boston. He says no one should have to pay for a botched operation. But he says some hospital infections are avoidable, others aren't.

Atul Gawande: And trying to sort out which are the right ones and then how much of the hospitalization was due to that infection, no one's quite figured out how to do that in a fair way.

Still, Gawande says, hospitals should brace themselves, because other health insurers are bound to follow suit.

I'm Ashley Milne-Tyte for Marketplace.

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