Nearly half of Connecticut hospitals – 14 out of 31 – will lose a portion of their Medicare payments in 2017 as a penalty for having too many patients who acquired preventable infections and injuries while hospitalized.
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.
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.”
“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.”
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.