Medicare beneficiaries will be able to resolve quality of care complaints against health care providers through a voluntary mediation program beginning this fall. The new program, sponsored by the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services, will bring together a provider or physician and a patient or his/her representative for a face-to-face meeting facilitated by an impartial mediator. This mediation is an alternative to the traditional medical record review process.
"Mediation allows a physician or health care provider to engage in a discussion with a patient who has filed a quality of care complaint against him or her," said David A. Bitonte, DO, MBA, FAOCA, Medical Director for Ohio KePRO, Ohio's Medicare Quality Improvement Organization. "It allows both parties a chance to tell their side of the story and resolve their disputes in a neutral and confidential environment."
Dr. Bitonte emphasized that mediation is not available if a serious quality of care concern appears to be involved. "However, with up to 80% of quality of care complaint cases driven by lack of communication or patients' concerns about their interaction with physicians, mediation can help resolve complaints faster, resulting in higher satisfaction rates for providers and patients alike," said Dr. Bitonte. "It will also help prevent the case from getting into the highly adversarial litigation process."
Currently, each beneficiary complaint goes through a medical record review process that can last from 85 to 165 days, depending on whether or not a quality of care concern is found.
For more information, visit www.ohiokepro.com