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.
As a practitioner at Yale-New Haven Hospital, Dr. Leora Horwitz has seen her share of patients who misunderstand medication changes made during their hospital stays. Just recently, one of her female patients, who was switched to a new beta blocker for high blood pressure during an inpatient stay, landed back in the hospital after discharge because she had taken both the new medication and her old beta blocker – a combination that lowered her heart rate and blood pressure to dangerous levels. “Every physician can tell you about these kinds of errors,” Horwitz said. “We do a relatively poor job of educating patients about their medications.”
As a researcher, Horwitz can now quantify those lapses. A recent study she led looked at 377 patients at Yale-New Haven Hospital, ages 64 and older, who had been admitted with heart failure, acute coronary syndrome or pneumonia, then discharged to home. Of that group, 307 patients – or 81 percent — either experienced a provider error in their discharge medications or had no understanding of at least one intended medication change.
Twenty-three Connecticut hospitals will forfeit Medicare funds in the next year under a new federal policy that penalizes hospitals with significant numbers of patients who are readmitted within a month of discharge.
Patients treated for pneumonia at four Connecticut hospitals have ended up readmitted to the hospital within 30 days at rates significantly higher than the national average—a lapse that the federal government considers costly and potentially harmful, and that could lead to Medicare penalties beginning in 2012.