Medicare Penalizes 26 CT Hospitals For High Readmission Rates

Twenty-six Connecticut hospitals will lose some of their Medicare reimbursement payments over the next year as penalties for having too many readmitted patients, new data from the Centers for Medicare and Medicaid Services (CMS) show. Nationally, Medicare is reducing payments to 2,499 hospitals, about 47% of all facilities, with the average penalty being 0.64%, according to a report by Kaiser Health News (KHN). This year’s penalties were based on tracking patients from July 1, 2017 through Dec. 1, 2019, so the influx of patient care during the pandemic is not included, CMS said. In Connecticut, 72 % of all hospitals in the program will face a loss in CMS payments, beginning October 2021 through September 2022.

State To Change ‘Problematic’ Health Care Pay Model

For decades, Connecticut and other states have used a fee-for-service model to pay for health care: the provider bills for each service, every consult, every procedure, every test, every pill. State Comptroller Kevin Lembo and many others have come to view that system as seriously flawed. It not only contributes to skyrocketing medical costs but also fails to deliver optimum care, Lembo said. “The incentives in that model are problematic,” Assistant Comptroller Josh Wojcik said. “It incentivizes volume.

Inspection Reports: Hospitals Cited For Testing Error That Resulted In Unnecessary Surgery, Patient Deaths, Failure To Investigate Complaint Of Patient Abuse

A hysterectomy performed on a patient based on a faulty test result, and the death of two patients after failing to receive necessary monitoring or medication, failure to immediately investigate a complaint of patient abuse by a doctor, were among the incidents cited in the latest round of hospital inspection reports conducted by the state Department of Public Health (DPH). The 24 new reports, which can be found in C-HIT’s Data Mine Section, cover state inspections that took place at hospitals last year and earlier this year. At Bridgeport Hospital, a patient underwent a total hysterectomy after her biopsy results were contaminated by another patient’s. The patient had a hysteroscopy procedure on Dec. 3, 2018, during which a biopsy was taken.

26 Hospitals Penalized By Medicare For High Readmission Rates

Most Connecticut hospitals will lose a percentage of their Medicare reimbursement payments over the next year as penalties for having high rates of readmitted patients, according to new data from the Centers for Medicare and Medicaid Services (CMS). Statewide, 26 of the 29 hospitals evaluated – 90 percent – will have their reimbursements reduced, by varying amounts, in the 2020 fiscal year that began Oct. 1, according to a Kaiser Health News analysis of data from CMS.

CMS began in the 2013 fiscal year to penalize hospitals that have high rates of patients who are readmitted within one month of being discharged. The penalties were enacted as part of the Affordable Care Act, intended to encourage better health care delivery. Nationwide, 2,583 hospitals will be penalized this year, according to Kaiser Health News.

Menopause’s Long Learning Curve

Every day an estimated 6,000 women in the U.S. reach menopause, a natural part of aging. But for countless women, it feels like anything but. The symptoms, which range from merely bothersome to debilitating, are triggered by the body’s loss of estrogen, which occurs at a median age of 50 to 52 among women in industrialized countries. Vasomotor symptoms alone (hot flashes, night sweats), which disrupt sleep and count as the most commonly reported complaint, last an average of 10 years and affect nearly 90 percent of menopausal women. A recent study published in the journal Menopause found that 250,000 women who suffered from hot flashes lost a cumulative $300 million per year in wages due to lost productivity and doctor visits, compared to asymptomatic women.

Medicare Cuts Payments To 15 Hospitals For High Infection Rates, Injuries

Fifteen Connecticut hospitals will lose 1 percent of their Medicare reimbursements this fiscal year as penalties for having relatively high rates of hospital-acquired conditions, data from the Centers for Medicare & Medicaid Services (CMS) show. The hospitals are among 800 nationwide being penalized – the highest number since the federal Hospital Acquired Conditions Reduction Program started five years ago, according to a Kaiser Health News (KHN) analysis of the CMS data. The penalties will be levied during the current fiscal year, which began in October 2018 and runs through September. Under the program, which was created by the Affordable Care Act, the government levies penalties based on hospitals’ rates of infection related to colon surgeries, hysterectomies, urinary tract catheters and central lines inserted into veins.  It also reviews infection rates for Methicillin-resistant Staphylococcus aureus, or MRSA, and Clostridium difficile, known as C. diff, as well as rates of blood clots, sepsis, post-surgery wounds, bedsores and hip fractures, among other injuries.

Hospital Errors Decline, But Reports Of Pressure Ulcers, Falls And Burns Climb

Connecticut hospitals reported increases in patients suffering from pressure ulcers, as well as serious injuries or deaths associated with falls and burns in 2017, compared to 2016, according to a new state report. Overall, the total number of “adverse events” reported by hospitals dropped from 431 in 2016 to 351 in 2017, a 19 percent decline, the Department of Public Health (DPH) said. But most of the decline was due to the elimination of two categories in 2017: serious injuries or death resulting from perforations during open, laparoscopic or endoscopic procedures; and those resulting from surgeries. Together those categories accounted for 72 adverse events in 2016. The reporting requirement for the two categories was eliminated after a work group of the Quality in Health Care Advisory Committee concluded that the vast majority of perforations that occur during some procedures aren’t preventable, and that serious injuries or death resulting from surgery are already better captured by other categories, the DPH report said.

Hospitals Bill More Than $1 Billion In Facility Fees Over Two Years

Connecticut consumers were billed for more than $1 billion in facility fees for outpatient services in 2015 and 2016, documents filed with the state Office of Health Care Access (OHCA) show. Twenty-two of Connecticut’s 30 hospitals charged these fees, bringing in $600.7 million in 2015 and another $488.8 million in 2016, according to an analysis by Conn. Health I-Team. The state’s two largest hospital systems, Yale New Haven Health and Hartford HealthCare, accounted for almost half of the total facility fee revenue in 2016. Yale and its four hospitals billed $144.3 million; Hartford and its five hospitals, $80.9 million.