WellPoint, a health benefits company, has announced system-wide process changes for its national provider network to be implemented in 2008.
The changes include reimbursement modifications aimed at eliminating preventable adverse events as defined by the Centers for Medicare and Medicaid Services (CMS) and the National Quality Forum (NQF). They will help protect WellPoint’s 35 million members from additional payments resulting from these errors.
WellPoint’s first phase of this initiative includes 11 preventable adverse events and will be modified and expanded in the future. This allows the company to work alongside hospitals to address the preventability of events as soon as possible and continue to monitor the activities related to the list of events from federal, state and private payers, and make adjustments as necessary and appropriate.
Sam Nussbaum, executive vice president for clinical health policy and chief medical officer, said: Our primary focus is to help ensure that physicians and hospitals are using appropriate processes, technologies and strategies to address ‘never events’ and, ultimately, to enhance the quality of care delivered to hospitalized patients.