WellPoint Announces Initiative Aimed At Preventing Serious Medical Errors

Company Committed To Protecting Members' Health And Finances By Not Reimbursing Major Preventable Adverse Events

April 1, 2008

INDIANAPOLIS —WellPoint, Inc., the nation's largest health benefits company, announced today system-wide process changes for its national provider network to be implemented this year.

The changes will include reimbursement modifications and are 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.

"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," said Sam Nussbaum, MD, executive vice president for clinical health policy and chief medical officer. "We will continue to work collaboratively with physicians and hospitals to analyze why and how these events occur, and to proactively find ways to improve patient safety and clinical care." 

WellPoint's first phase of this initiative includes 11 preventable adverse events and will be modified and expanded in the future. The company recently communicated to its network hospitals about its policy intended to ensure that no one will be charged if any of the following three events occur:

• Surgery performed on the wrong body part;
• Surgery performed on the wrong patient; and
• Wrong surgery performed on a patient.

In addition, WellPoint's changes will help ensure that only the appropriate payment is made and no additional charges are incurred if any of these events occur:

• Object left in the body during surgery;
• Air embolism or blockage;
• Blood incompatibility;
• Catheter-associated urinary tract infection;
• Decubitus (pressure) ulcers;
• Vascular catheter-associated infection;
• Mediastinitis (an infection inside the chest) after coronary artery bypass graft (CABG)  surgery; and
• Hospital-acquired injuries such as fractures, dislocations, intracranial injuries, crushing injuries and burns.

"We are listening to our members, business coalitions, and our key accounts who want to know their health plan is looking out for them," said Dr. Nussbaum. "As a strong advocate for patient safety, WellPoint firmly believes that putting processes in place that focus on preventing these events can have an immediate impact on health care safety and quality."

"It is critical that the entire health care system be looking for ways to improve safety and reduce harmful medical mistakes," said Bruce E. Bradley, director of Health Plan Strategy and Public Policy for General Motors Health Care Initiatives. "General Motors applauds WellPoint for implementing policies to help eliminate these costly adverse events."

WellPoint is in the early stages of implementation. This allows the company to work alongside hospitals to address the preventability of these 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.

WellPoint has long been committed to promoting patient safety including:

• Inclusion of patient safety metrics in WellPoint's core hospital pay-for-performance scorecard program as well as the Member Health Index (MHI) program, the first program in the industry to track and compare the collective health of all health plan members based on 20 clinical areas and 40 separate component measures;
• Support for the Institute for Healthcare Improvement's (IHI) 5 Million Lives campaign, a voluntary initiative to protect patients from five million incidents of medical harm through December 2008; and
• Participation in Leapfrog's patient safety survey to reduce preventable medical mistakes and improve the quality and affordability of health care.

"WellPoint's efforts to concentrate on patient safety and work toward eliminating avoidable hospital errors are commendable and commensurate with our goals for a safer health care system that must realign itself to pay on the basis of safety and quality," said Diane Pinakiewicz, president of the National Patient Safety Foundation. "It is important that our industry find ways to correct the systems issues that allow avoidable errors to occur, and WellPoint's leadership in the field will help move us in this direction."

About WellPoint Inc.
WellPoint, Inc. is the largest health benefits company in terms of commercial membership in the United States.  WellPoint's mission is to improve the lives of the people it serves and the health of its communities. Through its nationwide networks, the company delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, pharmacy benefit management, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts.  Headquartered in Indianapolis, Indiana, WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as Empire Blue Cross Blue Shield in 10 New York City metropolitan and surrounding counties and as Empire Blue Cross or Empire Blue Cross Blue Shield in selected upstate counties only), Ohio, Virginia (excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.), Wisconsin; and through UniCare.  Additional information about WellPoint is available at www.wellpoint.com.