Hospitals’ ‘Team Effort’ Reduces Number Penalized For High Infection Rates, Injuries

Six Connecticut hospitals will lose 1% of their Medicare reimbursements this fiscal year under a federal program that levies penalties for high rates of hospital-acquired injuries and infections. It’s the lowest number of hospitals penalized since the program began leveling funding cuts in 2015, data from the Centers for Medicare & Medicaid Services (CMS) show. The hospitals are among 774 nationwide that will lose funding under the Hospital-Acquired Conditions Reduction Program, according to a Kaiser Health News analysis. The program was created by the Affordable Care Act. When assessing hospitals, the government examines how many infections and other potentially avoidable complications patients suffered – things like blood clots, sepsis, bedsores and hip fractures.

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.

Medicaid Expansion Helped Reduce Disparities In Cancer Care

The racial disparity between white and black cancer patients in accessing timely treatments has virtually disappeared in states where Medicaid expanded under the Affordable Care Act (ACA), according to a new study. Yale Cancer Center researchers analyzed more than 30,000 health records and found that, prior to Medicaid expansion, black adults with advanced or metastatic cancer were 4.8 percentage points less likely than white adults to begin treatments within 30 days of being diagnosed. But in states where Medicaid was expanded, in 2014 or later, the percentage of black patients getting timely treatment rose from 43.5 percent to 49.6 percent. There also was a small improvement in expansion states among white patients receiving timely treatment – from 48.3 percent to 50.3 percent – bringing the post-expansion difference between the two racial groups to less than one percentage point. “Our results suggest that Medicaid expansion led to improved health equity,” said study author Amy Davidoff, a senior research scientist at Yale School of Public Health and in Yale Cancer Center’s Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER).

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.

Pharma Cash Flows To Doctors For Consultant Work Despite Scrutiny

With physicians’ compensation from pharmaceutical and medical device companies under increasing scrutiny, payments to doctors in Connecticut for consultant work rose to $8.5 million in 2017, up from $8 million in 2016. Payments for meals, travel and gifts also increased from $3.2 million in 2016 to $3.5 million in 2017, data from the Centers for Medicare & Medicaid Services show. Of the total $27.2 million in payments, $4.37 million – or 16 percent – went to 10 doctors holding licenses in Connecticut. The highest paid doctor was Dr. Paul Sethi, an orthopedic surgeon in Greenwich, who accepted slightly more than $1 million in 2017 in royalty fees, consulting work, and other services from several companies, including Arthrex Inc., and Pacira Pharmaceuticals Inc., maker of Exparel. The drug, Exparel, is marketed as an alternative to opioid painkillers post-surgery.

Health Insurance Open Enrollment Begins Nov. 1; You Can Window Shop Starting Today

Consumers will have the shortest open enrollment period yet to shop for 2019 health insurance plans – 45 days — but they can “window shop” and compare plans beginning today. Open enrollment for health plans effective Jan. 1, 2019, will run from Nov. 1 to Dec. 15, giving consumers the least amount of time to enroll in or renew plans since the Affordable Care Act (ACA) became law.

Costs And Access Still Barriers To Health Care, Survey Finds

Iasiah Brown, 25, of New Haven, said he does not see a need for a primary care doctor for himself and his daughter, opting to visit clinics in the area instead of waiting up to two weeks for an appointment at a doctor’s office. Brown is among the 83 people who said they didn’t have a primary care doctor in response to a health-care usage survey by the Conn. Health I-Team and Southern Connecticut State University. The team surveyed 500 people and interviewed dozens statewide between January and March. About 83 percent of respondents said they had a primary care doctor, but the rate was lower for African American (78 percent) and Hispanic respondents (75 percent).