The Betsy Lehman Center estimates that each year Massachusetts health plans pay $2.14 billion in claims for additional care provided to patients harmed during hospitalizations. At least $446 million of the total is paid by MassHealth.
The Center issued an update to its 2019 report on the cost of medical harm in Massachusetts using claims data and new research on the incidence of harm to patients in hospitals. The Center is seeking state investment in a hospital pilot of automated adverse event monitoring that aims to achieve unprecedented reductions in harm and provide a substantial return on investment for the state.
“Health care providers and others have tried for decades to reduce the incidence of preventable harm events but have been held back by the lack of timely information,” says David Bates, M.D., a professor and researcher at Harvard Medical School. “Automated monitoring gives hospitals near-real-time access to critical information that’s hiding in plain sight — in patients’ electronic medical records — enabling them to respond quickly and prevent future harm.”
“Massachusetts is positioned to break new ground on patient safety, saving both lives and money,” says Barbara Fain, Executive Director of the Betsy Lehman Center. “Residents of the Commonwealth, liability insurers, healthcare providers, and payers — including the state — would all benefit.”
The pilot will bring automated adverse event monitoring to 6-8 Massachusetts acute care hospitals. This new approach scans electronic medical records to detect harm events in near real-time, making it practical for clinical teams to manage and reduce harm in daily operations. Hospitals in other states have reduced harm events by 25% on average, with some hospitals achieving even greater reductions over time.
The Betsy Lehman Center projects that, during the initial pilot, 4,487 patient harm events would be prevented at a savings of $54 million to all payers. Longer term, with adoption of automated adverse event monitoring by all Massachusetts acute care hospitals, payers could save nearly $536 million each year, with $111 million of those savings realized by MassHealth.
The report notes that its analysis doesn’t include the financial costs of harm to patients and families from lost wages, added living expenses or additional out-of-pocket costs for medical care. Also missing are the costs that hospitals absorb, mainly in the form of lost revenues from extended stays for which they are not reimbursed under their health plan contracts. Finally, the cost analysis does not reflect how harm events impact patient and workforce well-being and strain system capacity.
“Improving health care safety is a moral imperative,” says Michelle Anderson, a nurse and patient advocate. “These numbers represent real people who feel the biggest impact when things go wrong during their medical care. This work saves lives — but saving lives and saving money, that’s a win-win.”
