Feds Penalize Hospitals For Inflection Rates

The federal government is penalizing more than 700 hospitals across the country for having high rates of hospital acquired infections. In Connecticut, 14 hospitals are facing the penalty and consequently losing millions of dollars. The Patient Protection and Affordable Care Act includes provisions intended not only to improve access to healthcare but also to improve healthcare itself.  According to the law, hospitals that do the worst get penalized and lose one percent of their Medicare payments over the course of the year.

In Connecticut, 45 percent of hospitals in the program were penalized – among the highest rates in the nation. However, some hospitals that were penalized, including Yale-New Haven Hospital, argue that the federal government’s specific data set has problems. Yale’s leaders believe that hospitals like theirs have improved and that the data does not take important factors, such as hospitals with higher rates of less healthy patients, into account. However, unless lawmakers decide to strip the provision in the health law, the penalty will remain and come back again next year.

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Tenet CEO: Plans To Acquire CT Hospitals Could Be Revived

The CEO of Tenet Healthcare, Trevor Fetter, has sent a letter to Connecticut Governor Dannel P. Malloy saying that he is open to coming back to the negotiating table to acquire five Connecticut hospitals if the state loosens some of its regulatory requirements. Several conditions would have to exist for Tenet to reconsider acquiring Waterbury, St. Mary’s, Bristol, Manchester Memorial, and Rockville General hospitals. Fetter emphasizes that any conditions placed on its deals must apply equally to all hospitals in the state as well as other organizations interested in buying a hospital in Connecticut – whether they are nonprofit or for-profit operators. Malloy sent a letter earlier this month urging Fetter to send a Tenet representative to meet with Mark Ojakian, the governor’s chief of staff, to negotiate a deal. In December, Tenet pulled out of its plan to acquire five Connecticut hospitals after state regulators issued 68 conditions on the purchase that would bar layoffs and price increases for at least five years.

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New Rules Discourage Nonprofit Hospitals’ Use Of Aggressive Tactics To Collect Payments

The Obama administration has adopted new rules that limit nonprofit hospitals from using “aggressive tactics” to collect payments from low-income patients. Instead, nonprofit hospitals must offer discounts, free care, or other financial assistance to certain types of needy patients. Furthermore, hospitals must also determine whether a patient is eligible for financial assistance before they refer the case to a debt collector, send information to a credit agency, place a lien on a patient’s home, file a lawsuit, or seek a court order to seize a patient’s earnings. Advocates of the new rules believe they will make it easier for low and moderate-income people to get care without worrying about the financial consequences. Additionally, under the new rules, each nonprofit hospital must assess the health needs of its community at least once every three years and establish and publicize a written financial policy stating who is eligible and how to apply.

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Tenet Abandons Plans To Acquire Connecticut Hospitals

Tenet Healthcare has officially pulled the plug (for now) on its acquisition of four Connecticut hospitals. Tenet notified government officials that it would not continue its pursuit of buying Waterbury Hospital, St. Mary’s Hospital, Bristol Hospital, and Eastern Connecticut Health Network to convert them from non-profit hospitals to for-profit ones. Tenet cites the extensive list of proposed conditions as reasons for pulling out of the four transactions. Tenet’s decision has widespread impact on Connecticut’s healthcare industry and also creates a political problem for Governor Dannel P. Malloy and his state legislature. Connecticut hospitals were depending on Tenet for capital to remain economically viable long-term and now may need to find other partners or ask the state legislature for funding increases.

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Study: Hospital Compare Scores Do Not Improve Outcomes

According to a study published in JAMA Internal Medicine, quality scores on Medicare’s Hospital Compare website aren’t likely to improve hospital outcomes. Researchers at Baystate Medical Center in Massachusetts sent 630 hospitals a 21-question poll in the fall of 2012 (before CMS implemented federal penalties affecting reimbursements) that addressed the participants’ Hospital Compare scores for measures involving cost, patient experience, process measures, volume, mortality and readmissions. 70 percent of the 380 hospitals that responded agreed that public reporting provides incentives to organizations to implement quality improvement initiatives. However, respondents did express concerns about the potential side effects of the metrics. 59 percent of respondents also expressed concerns that emphasis on publicly reported quality measures could come at the expense of other areas.

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Study: Improved Communication During Shift Changes Reduce Medical Errors

According to a new study published in the New England Journal of Medicine, better communication between physicians during shift changes can reduce medical errors and preventable adverse events. Researchers conducted a prospective intervention study of a resident handoff-improvement program in nine hospitals to measure rates of medical errors, preventable adverse events and miscommunications and resident workflow. The study required physicians to write down instructions during handoffs and read them back to make sure they understood them. The handoff involved physicians discussing details of the patient’s history and an action list of what needed to be done. This improved communication reduced medical errors by 23 percent and preventable adverse events by 30 percent. Other studies have shown that 80 percent of serious medical errors stem from miscommunication-typically during shift changes.

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CDC Officials Questioned About Ebola Response

Yesterday, CDC Director Tom Frieden and other top officials were questioned by members of the U.S. House Energy and Commerce Committee’s Subcommittee on Oversight and Investigations on the response to Ebola infections in the country. Most of the questions focused on why the U.S. had not issued a travel ban from Ebola-stricken countries. Frieden stated that restricting travel would mean that the CDC could not screen and track passengers as they entered the U.S., especially if they decided to enter the country under false pretenses via another country.

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