Can Independent Primary Care Doctors Survive Dominance of Hospital Health Systems?

Every day, Dr. Leslie Miller of Fairfield thinks about selling her practice to a hospital health system. “Everybody who is in this environment thinks every day of throwing in the towel and joining a hospital,” said Miller, a sole practitioner in primary care for 20 years. “The business side is the problem,” she said, referring to expensive and time-consuming requirements of medical insurance and government regulations. Dr. Khuram Ghumman took the unusual route of working in a hospital system first, then going into private primary care practice because he objects to the “corporatization” of health care. He said conflicts of interest can arise if an owner and its employed physicians have different objectives.

With Demand For Community Health Workers Rising, So Does Need For Sustainable Funding

New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and connects them with other health services. She even helps them find rental assistance. In and around New London, CHW Lizbeth Polo-Smith hands out flyers about COVID-19 safety and vaccinations at churches, laundromats, stores, warming centers for the homeless—anywhere she can. As COVID-19 laid bare Connecticut’s health care deserts, it now highlights the efforts of CHWs who labored in forgotten neighborhoods for years. In many ways, they have become a key factor in the state’s public health response for marginalized communities during the pandemic.

Medical Practices Become Another Pandemic Casualty

After 35 years as an oral surgeon, Dr. Arthur Wilk closed his practice in Clinton following “daunting challenges” caused by the COVID-19 pandemic. In Darien, Dr. Cecile Windels sold her pediatric practice to a hospital health system after enduring significant income losses. They are among thousands of physicians and other health care professionals across the country who have made coronavirus-prompted career changes such as closing practices, joining larger health systems and retiring early.  The reasons for the moves vary from declines in income due to fewer inpatient visits to increased operational costs for personal protective equipment (PPE) and fears of contracting the coronavirus known as SARS-CoV-2. Health care advocates say the changes will exacerbate physician shortages, further erode the existence of private practices, decrease patient choice of doctors and obstruct continuity of patient care. A January report in Health Affairs, a peer-reviewed journal of health policy research, said: “Consolidation tends to lead to higher prices without strong evidence of quality improvements.”

“The national trends are definitely happening in Connecticut,” said Dr. Gregory Shangold, president of the Connecticut State Medical Society.

2020 In Photos

Front-line health care workers pushed to the limit, extraordinary lines for food, surging demand for shelter  – these were some of the scenes as the pandemic swept through the state during this unprecedented year. Our photographers captured these moments and more as they illustrated a year’s worth of compelling stories. Scroll through the gallery to see C-HIT’s outstanding photography in 2020 by photographers Melanie Stengel, Steve Hamm, Carl Jordan Castro, Carol Leonetti Dannhauser and Cloe Poisson. And a shout-out to those who shared their photos of the moments our photographers couldn’t get to.

Connecticut’s Halfhearted Battle: Response To Lead Poisoning Epidemic Lacks Urgency

It wasn’t until Bridgeport lead inspector Charles Tate stepped outside the house on Wood Avenue that he saw, immediately, where 2-year-old Rocio Valladares was being poisoned. The paint around a window at the back of the house was deteriorating. Beneath the window was Rocio’s favorite play area, a sloping basement door that was the perfect ramp for an energetic toddler. Next to the basement door was a patch of dirt where she loved to scratch with sticks. White chips of paint were visible in the dirt.

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.

Medical Board Disciplines Two Doctors

The state Medical Examining Board agreed Tuesday to discipline two doctors including a physician awaiting sentencing in a federal health care fraud case. Dr. Fawad Hameedi, of New York, has been working periodically at urgent care centers in Connecticut while awaiting sentencing for his role in a health care fraud ring operating in New York, according to documents. He has not worked as a physician in Connecticut since March, officials said. The board voted to place Hameedi on probation for two years with several stipulations and reprimand his Connecticut license to practice medicine. Under the terms of the discipline, Hameedi cannot operate a solo practice during the probation period and he must have his employer submit reports to the state Department of Public Health (DPH) every two months that he is working safely and using accurate billing practices.

CT Veterans Suicide Rate Rises; VA Monitoring COVID-19’s Impact

In Connecticut, 47 veterans died by suicide in 2018, an increase of 10 from the previous year, newly released statistics show. The increase reflected a higher suicide rate than in the overall state population. The Connecticut veteran suicide rate was 25.1 per 100,000 compared with 14.6 in the overall state population. The state’s veteran suicide rate was 20.3 in 2017. The 2018 rate rose even though the state veterans population dropped by about 1,000 to 187,000.

Medicare Penalizes Hospitals For High Readmission Rates

Most Connecticut hospitals will lose some of their Medicare reimbursement payments over the next year as penalties for having too many readmitted patients, according to new data from the Centers for Medicare and Medicaid Services (CMS). Statewide, 25 of the hospitals evaluated – or 89% – will have reimbursements reduced, to varying degrees, in the 2021 fiscal year that started Oct. 1, according to a Kaiser Health News analysis of CMS data. Nationwide, almost half of hospitals, or 2,545 of them, will have their Medicare reimbursements cut, according to Kaiser Health News. The latest penalties were calculated using data from June 2016 through June 2019, meaning the influx of patients to hospitals seen amid the pandemic didn’t factor in.

Obamacare: What’s At Stake If The High Court Strikes Down The Law

Vyanne Dinh, 21, a senior at New York University, will be paying close attention next month when the U.S. Supreme Court hears arguments in a lawsuit backed by the Trump administration to overturn the Affordable Care Act (ACA). Thanks to the ACA, the law known as Obamacare, a provision allows young adults to remain on their parents’ health insurance policies until age 26. Dinh, of South Windsor, is covered on her mother’s policy. “If I lost coverage under my parents, I would not know what to do,” Dinh said. “Chances are I would have to handle medical expenses out of pocket, which would definitely cause a financial strain and make me hesitant to go to the doctor’s unless it is a dire emergency.”

“I am also worried about COVID because the risks are too high under current circumstances to be uninsured,” said Dinh.