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.

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.

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.

Efforts To Reduce COVID-19’s Spread Could Impact Health Outcomes For New Mothers And Infants

Felicia Tambascio’s first pregnancy was going fairly smoothly. But on July 20, at week 38, the 20-year-old Brookfield resident woke with horrible upper abdominal cramps, a searing headache, and vomiting. Her boyfriend took her to the hospital, but Tambascio was left to wait in a hallway alone. Per COVID-19 restrictions, no visitors were allowed unless the patient was admitted to labor and delivery. After it was discovered that Tambascio was suffering from the life-threatening condition preeclampsia, she was escorted to the labor and delivery ward and induced.

Hospital Errors Rose 7% In 2018

The number of “adverse events” occurring at Connecticut hospitals rose 7% in 2018, compared with the previous year, with a growing number of patients suffering serious injury or death associated with falls, according to a new state report. Overall, the total number adverse events, or medical errors, reported by hospitals rose to 376, from 351 in 2017, according to the state Department of Public Health (DPH). Of the 29 categories tracked, tallies rose in 12, declined in seven and remained flat in 10. “I’m very discouraged by the report,” said Lisa Freeman, executive director of the Connecticut Center for Patient Safety. “Some of these numbers, they give me chills, they’re so frightening.

Most OB-GYN Practices Fall Short In Caring For Women With Disabilities

Over the past 20 years, Connecticut women with cognitive or physical disabilities have found their way to the Gaylord Specialty Healthcare’s Gynecological Clinic for Women with Disabilities in Wallingford. There, obstetrician-gynecologist (ob-gyn) Anna Tirado provides routine and preventive gynecological care to disabled women. Now nearing retirement age, Tirado isn’t sure what will happen when she no longer sees patients. “I am very worried. The patients are not going to be easily absorbed into a private practice,” she said.

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.

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.