Fast Facts
-
The average cost of treating a bedsore in a hospital (acute care) is right around $43,000 per stay. (According to the Center for Medicare and Medicaid [CMS])
-
In 2004, more than 1 in 10 nursing home (long-term care) residents had a pressure ulcer. (According to the Center for Disease Control)
Cost Containment and Reduction
WoundVision can save healthcare facilities millions of dollars in preventable costs through the early detection of wounds and other complications from health issues. According to a report by the Agency for Healthcare Research and Quality, of the 1.4 million saftey incidents at US hospitals (out of 37 million hospital admissions) between 2000 and 2002, pressure ulcer were one of the three most common.[1] Reductions will occur in these cost centers associated with pressure ulcer treatment:
- Direct Costs for Wound Care (National Average is $550,000 per 165 bed facility)
- Annual direct cost of treating pressure ulcers in US hospitals in 2004 was estimated to range from $400,000 to $700,000 per year. [2]
- Litigation Costs ($250,000 median cost per judgment) [3]
- Other Costs Associated with the Complications of Immobility such as Falls, DVT, UTI, Pneumonia (Average $500 to $40,000 per incident) [4]
Revenue Preservation
Healthcare reimbursement rule changes have become challenging for many facilities as they watch previously reimbursed practices reduced or negated. WoundVision’s detailed reports can assist your facility in minimizing coding errors and improving proper documentation practices to prevent:
- RAC Audit Losses (Hundreds of $Millions are estimated to be recovered in 2011 due to improper coding for Medicare)
-FY 2010 - $92.3M
-Oct 2010-Mar 2011 - 273.5M
www.racaudits.com
- Fines for Regularly Submitted Fraudulent and/or Inconsisten Claims ($5,500-11,000 per violation + damages up to 3x the erroneous payment) [5]
- Pressure Ulcer Occurrence Fines ($10,000 per/Long Term Care Only)
| -$900+ million from providers for incorrect Medicare claims |
| - 40% from claims for services deemed medically unnecessary |
| - 35% linked to coding errors |
| - 8% linked to insufficient documentation |
| www.hhnmag.com |
Early detection pays off big
Data from Hospital Acquired Conditions / Medicare's No Payment Policy
| Patient Situation Secondary diagnosis of Stage I, II, or unstaged pressure ulcer |
Reimbursement $7,015 |
| Patient Situation Admitted with the same principal diagnosis and documented evidence |
Reimbursement $10,144 |
| Patient Situation Admitted with the same principle diagnosis but develops a Stage III or IV pressure ulcer during the hospital stay but was not documented upon admission |
Reimbursement $7,015 |
Long Term Care Facilities/Hospitals
What it means to you per incident:
| Pressure Ulcer | $3,259 to $52,93 |
| Venous Stasis Ulcer | $9,695 per patient |
| Neuropathic Ulcer | $16,000 to $28,000 per incident |
| UTI (catheter) | $44,043 per hospital stay |
| Deep Vein Thrombosis | $10,000 per occurrence |
| Pulmonary Embolism | $20,000 per occurrence |
| Hospital-acquired pneumonia | $40,000 per patient (increases hospital stays by 7-9 days) |
| Falls | $17,500 per hospital stay |
| Hospital-acquired infection | $21,700 more than for a patient without an infection |
| Potential Cost for Only One Incident Per Type | $208,000 |
| *Not including regulatory citations/fines or legal costs |
| [1]Ducker A. Pressure ulcers: assessment, prevention, and compliance. Case Manager. 2002; 13(4): 61-65 [2]Pompeo MG.The role of "wound burden" in determining the costs associated with wound care. Ostomy Wound Management. 2001; 47(3): 65-71 [3]Bennet RG, O'Sullivan JO, DeVito EM, Remsburg R.J AM Geriatric Soc. 2000; 48(1): 73-81 [4]Lyder C. Pressure ulcer prevention and management. Ann Rev Nurs Res. 2002; 20: 35-61 [5]False Claims Act, 31 U.S.C. 55 3729-3733 |