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.
Getting to the hospital quickly after suffering a stroke improves your chances of survival, but in Connecticut there are areas where access to the top level of stroke care is limited, health experts say. Two hospitals, Yale New Haven Hospital’s main campus and Hartford Hospital, are nationally certified as Comprehensive Stroke Care Centers, providing the highest level of stroke care available, which includes 24-hour access to neurological practitioners and the ability to perform complex endovascular therapies, including thrombectomies and endovascular coiling of an aneurysm, among other surgeries. Yale and Hartford hospitals are two of only 178 certified nationally as comprehensive stroke centers, according to The Joint Commission, which certifies hospitals. But when time is critical, traveling to New Haven or Hartford can be a risky commute from the northwestern and northeastern parts and other parts of the state, where hospitals certified in stroke care are sparse. In all, the state has 23 hospitals that are certified in some level of stroke care, up from 16 in 2013.
When Adam Berger, 29, who has Type 1 diabetes, decided to get a sandwich from a deli, he first ran it by his mobile application ezbds, which he launched in Stamford two years ago. The app told him that in the past when he’d eaten that particular sandwich from the same deli, he hadn’t experienced glucose spikes. “So I decided to stick with it,” Berger said. “An hour later when ezbds reminded me to check, my glucose was 123.” That’s a good number according to the American Diabetes Association (ADA), which suggests a target of less than 180 mg/dL an hour or two after beginning a meal for adults with diabetes. “By tracking what they eat, people can identify how certain foods affect their blood sugar,” said Nancy Salem, coordinator of the Diabetes Education Program at Danbury Hospital.
Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.
Connecticut hospitals reported fewer numbers of patients killed or seriously injured by falls or perforations during surgery or suffering from severe pressure ulcers in 2014 than in 2013, but the incidence of such “adverse events” still remains higher than in 2012, a new state report shows. The report by the Department of Public Health (DPH) shows that the total number of hospital adverse events, or errors, dropped by 12 percent — from 534 in 2013, to 471 last year. Deaths or serious injuries from falls declined from 90 to 78; perforations during surgical procedures fell from 79 to 70; and life-threatening medication errors fell from six to one. The number of patients with serious pressure ulcers dropped from 277 to 245. Rates of all four of those incidents had climbed in 2013, in part because of an expansion of required reporting on pressure sores to include “unstageable” ulcers.
The growing number of children and teens exposed to traumatic events in everyday life has forced the state’s crisis intervention teams to respond to a broader range of behavioral and mental health issues, and those teams often serve as a bridge until at-risk youth find appropriate outpatient or inpatient services. Sixty-four percent of Connecticut’s youth who use Emergency Mobile Psychiatric Services (EMPS), the state’s mobile crisis intervention team, have experienced one or more traumatic incidents, such as domestic violence, cyber-bullying, physical assaults, or gang warfare, experts report. Research shows childhood exposure to violence, physical or sexual abuse, and other traumatic events can cause chronic health and behavioral health problems, and such exposure is associated with increased involvement with the child welfare and criminal justice systems.
“The number of children who have been exposed to trauma is a significant concern. It’s a common occurrence among young people,” said Jeffrey Vanderploeg, vice president for mental health initiatives for the Child Health and Development Institute of Connecticut (CHDI). He is director of the EMPS Performance Improvement Center, which is housed at CHDI.
Connecticut’s diabetes rate ranks lower than the national average, but Hispanics and African-Americans are more than twice as likely to have the disease compared with their white neighbors and are at greater risk of dying from diabetes-related causes. Approximately 250,000 Connecticut adults (8 percent) have been diagnosed with Type 2 diabetes and an estimated 83,000 state residents don’t realize they have the disease, according to 2011-13 data from the U.S. Centers for Disease Control and Prevention (CDC). Nationally, 29.1 million people (9.3 percent) have diabetes and 8.1 million people don’t know they have the disease, reports the CDC. Connecticut’s Hispanics (14.6 percent) and African-Americans (14.1 percent) have significantly higher rates of diabetes than whites (6.7 percent). In addition, adults with annual household incomes below $25,000 are 2.3 times more likely to have diagnosed diabetes compared with adults with household incomes over $75,000, according to the CDC.
Candid online posts describing the challenges of breastfeeding fill the Facebook page of Breastfeeding USA’s Connecticut chapter. The daily stream of anecdotes, questions and comments alternate in tone from exasperated to celebratory. “Small victory for today. I actually breastfed in the open with my husband and day care provider in the same room (with a nursing cover, of course), but I haven’t done that yet, so I feel good about it. “
As the state works to improve its mental health system, new federal data show that hospitals in Connecticut restrain psychiatric patients at more than double the average national rate, with elderly patients facing restraint at a rate seven times the national average. In addition, the state lags behind in providing adequate post-discharge continuing care plans for psychiatric patients, especially teens and the elderly. Connecticut’s 28 inpatient psychiatric units and hospitals developed continuing-care plans for fewer than 70 percent of patients they discharged from October 2012 to March 2013 – indicating that thousands of patients may have left facilities without adequate treatment and medication plans. A C-HIT analysis of the federal data, released by the Centers for Medicare & Medicaid Services for the first time, show that Connecticut ranks in the top fourth of states (11th highest) in the use of physical restraints in inpatient psychiatric facilities – and is the third highest state in restraining patients 65 and older. Two psychiatric units – at Bridgeport Hospital and Masonicare Health Center in Wallingford – have the 10th and 12th highest rates of restraint use, respectively, among the 1,753 psychiatric facilities nationwide that are included in the federal reports, which cover October 2012 through March 2013.
Connecticut fared second-worst in the country in the percentage of hospitals hit with federal penalties for selected quality-of-care measures and in the overall rate of loss of Medicare reimbursements associated with those penalties, new federal data shows. Eighty-six percent of the state’s 30 acute-care hospitals were penalized under Medicare’s Value-Based Purchasing Program, an incentive program created under the Affordable Care Act to reward hospitals on a number of quality measures related to treatment of patients with heart attack, heart failure, pneumonia and certain surgical issues, as well as patient satisfaction. Overall, the state’s hospitals lost .15 percent of their Medicare reimbursement, compared to a .02 percent average loss nationally, the data shows. In addition to the penalties on quality measures, 23 Connecticut hospitals lost Medicare funding because of high rates of readmitting patients within 30 days of a hospital stay. Four faced the maximum loss, a 1 percent reduction in funding: Griffin Hospital in Derby, the Hospital of St.