In this year’s evaluation, CMS considered the COVID-19 pandemic and its impact on hospitals, excluding data for the first half of 2020 and Medicare patients readmitted with pneumonia, according to a report in Kaiser Health News.
Nationally, Medicare is penalizing 2,273 hospitals, the fewest since 2014, with an average payment reduction of 0.43%, Kaiser reported.
Hartford Health Care Photo.
CMS fined William Backus Hospital 1.42%.
In Connecticut, 69% of all hospitals in the program face fines, but most are under 1%.
Six hospitals saw significant drops in penalties, including Rockville Hospital, from 2.3% last year to 0.45% this year, and Bridgeport Hospital, from 2.15% to 0.7%.
The others are Bristol Hospital, from 1.34% to 0.28%; Manchester Memorial Hospital, from 1.8% to 0.74%; Middlesex Hospital, from 1.67% to 0.97%; and Waterbury Hospital, from 1.13% to 0.51%.
William Backus Hospital received the highest penalty this year among facilities in the state, at 1.42%, which is slightly lower than last year’s 1.56%.
“We are encouraged that many hospitals in our state showed improvement from last year or sustained past gains,” Alison Vail, RN, vice president of quality and patient safety, Connecticut Hospital Association, said in an email. “Through the Connecticut Hospital Association, hospitals are working collaboratively and transparently to improve the quality of care delivered at hospitals and to focus on patient care needs outside the hospital walls.
“This ongoing collaboration is having a positive effect on patient care,” Vail said. “These efforts to support patients through programs that address social and health care needs will improve patients’ quality of life and minimize the need for hospital readmissions. Hospitals and health systems are committed to continuous quality improvement and will continue working together to achieve even better outcomes for patients.”
Lisa Freeman
Lisa Freeman, executive director of the Connecticut Center for Patient Safety, said, “It is important to move the focus from the monetary consequence of readmissions to the causal reason for them. While I commend our hospitals for much of the good work that was done, COVID or not, readmissions can and should be greatly reduced with well-coordinated hospital care, discharge planning, and aftercare.
“COVID provided a stress test for our health care system, and that provided a window through which the weaknesses that showed up should be identified and addressed,” Freeman said. “As much as hospitals don’t want to be penalized, for many reasons, patients don’t want to be readmitted either. Effective communication among all members of the patient care team, including the patient and home caregiver, coupled with consideration of discharge readiness and medication reconciliation as well as the other related factors must always be addressed—COVID or not.
The hospitals losing less than 1% reimbursement are Charlotte Hungerford, .38%; Danbury, .23%; Day Kimball, .77%; Greenwich, .24%; Hartford, 0.71%; John Dempsey, .58%; Johnson Memorial, .27%; and Lawrence + Memorial, .18%.
Also losing less than 1% reimbursement are MidState Medical, 0.62%; Norwalk, 0.09%; St. Mary’s, 0.6%; Sharon, 0.11%; St. Francis, 0.33%; St. Vincent’s, 0.54%; Stamford, 0.04%; Hospital of Central Connecticut, 0.08%; Windham Memorial, 0.15%; and Yale New Haven, 0.41%.
Griffin Hospital in Derby, Masonicare Health Center in Wallingford, Hebrew Home and Hospital Inc. in West Hartford and Connecticut Hospice Inc., Branford, were not penalized.
Connecticut hospitals exempt from the program include Connecticut Children’s in Hartford, Connecticut Valley Hospital in Middletown, Natchaug Hospital in Mansfield, Connecticut Mental Health Center in New Haven, Southwest Connecticut Mental Health in Bridgeport, Silver Hill Hospital Inc. in New Canaan and Albert J. Solnit Children’s Center in Middletown.
This is the 11th year for CMS penalties, enacted under the Affordable Care Act. The maximum penalty is 3%. The penalties take effect as of Oct. 1.
]]>The hospitals are among 769 nationwide that will lose one percent of their Medicare reimbursements this year as part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program.
This is the third year in a row that Bridgeport Hospital has been penalized.
The CMS program, now in its third year, penalizes the lowest-performing hospitals where a relatively high number of patients got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also takes into account patients who suffered from blood clots, bed sores or falls while hospitalized.
New this year, CMS also factored in the incidents where antibiotic-resistant bacteria – namely, methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C. diff) spread.
Slightly fewer Connecticut hospitals are being penalized this year than last year; 18 lost a portion of their Medicare payments in 2016.
Hospitals being penalized this year include some of the state’s largest, such as Hartford Hospital and St. Francis Hospital and Medical Center in Hartford, and Yale New Haven Hospital and Bridgeport Hospital. But smaller hospitals also made the list, including Masonic Health Center in Wallingford, Charlotte Hungerford Hospital in Torrington, and Johnson Memorial Hospital in Stafford Springs.
Hospitals statewide place a strong emphasis on patient safety, and the outcomes reflect that, said Dr. Mary Cooper, vice president and chief quality officer at the Connecticut Hospital Association.
“The hospitals here in Connecticut are improving,” she said. “That’s the great news.”
Cooper said improvements are largely due to hospitals embracing “high-reliability” standards, which help staff and doctors better anticipate and prevent patient harm.
“The outcomes that we are seeing are a result of everybody paying attention and lots of knowledge being shared,” she said.
Lisa Freeman, executive director of the Connecticut Center for Patient Safety, agrees that hospital are making strides in some areas, thanks in large part to the high-reliability standards. But Freeman said, “As long as any patients are getting hospital-acquired infections and conditions, there needs to be improvement.”
Griffin Hospital is among nine hospitals that have never been penalized under this program.
“The good news that comes out of this is that when hospitals focus on fixing a particular problem, they come up with solutions,” Freeman said. “But there’s still all the other specific areas” that need attention.
Seven Connecticut hospitals have been penalized in all three of the years since the program launched, according to CMS. They are: Bridgeport; Connecticut Hospice Inc. in Branford; Hartford; the Hospital of Central Connecticut in New Britain; John Dempsey Hospital in Farmington; Windham Community Memorial Hospital and Yale New Haven.
Additionally, four other hospitals are being penalized in 2017 for the second consecutive year: Charlotte Hungerford, Lawrence + Memorial Hospital in New London; St. Mary’s Hospital in Waterbury, and St. Francis Hospital.
There are nine hospitals that have never been penalized under this program. They are: Bristol Hospital, Connecticut Children’s Medical Center in Hartford, Griffin Hospital in Derby, Hebrew Home & Hospital in West Hartford, MidState Medical Center in Meriden, Milford Hospital, Sharon Hospital, St. Vincent’s Medical Center in Bridgeport, and William Backus Hospital in Norwich.
High-reliability standards began rolling out in Connecticut in 2013, and to date, more than 50,000 health care workers statewide have received training in the program, Cooper said. The practice is spreading, and other states are looking to Connecticut as a model, she added.
High-reliability involves making concerted efforts to keep patients safe – such as double-checking dosages before administering medications, taking “timeouts” during surgeries to make sure procedures are being correctly, and implementing safety checklists.
“I commend the hospital association for putting their efforts into the high-reliability practice,” Freeman said. “High-reliability is a great strategy to use. It’s wonderful for processes and treatment, and situations where there is a lot of consistency in what needs to be done. It’s one piece of the answer.”
Yale New Haven Hospital has been penalized all three years.
But more must happen to ensure that patients aren’t getting infections while hospitalized, she said. A further culture shift is needed so that hospital employees value patient input and feedback, she said, and hospitals need to focus on the over-prescription of antibiotics, since a growing number of bacteria are becoming resistant to them.
Hospitals also should reiterate to employees how effective simple hand washing can be in preventing the spread of bacteria and infections, Freeman said.
Hospitals have taken many positive steps, she said, “but it’s not enough yet.”
To view the CT hospital penalties click here.