The Centers for Medicare & Medicaid Services will penalize most Connecticut hospitals over the next year by withholding a portion of their Medicare reimbursement payments for having high rates of patient readmissions.
While this news — reported recently by the nonprofit Connecticut Health Investigative Team, based on a Kaiser Health News analysis — is unlikely to be seen by the hospitals as a good thing, it may be leading toward a new understanding of a hospital’s mission that can bring about better patient outcomes.
Nationally, hospitals will lose $566 million in penalties, which were instituted as part of the Affordable Care Act to encourage better health care delivery. In Connecticut, Waterbury Hospital will take the hardest hit, losing 2.19 percent of its Medicare reimbursement. Meriden’s MidState Medical Center did much better, at 1.37 percent, and Yale New Haven Hospital came in at 1.03 percent. Norwalk Hospital had the lowest penalty at 0.02 percent, and two facilities suffered no reduction.
This year for the first time, CMS is comparing hospitals in “peer groups” that serve similar proportions of low-income patients, in order to be more fair to “safety net” hospitals — those that largely serve low-income patients, who are less likely to have a primary physician or seek follow-up care.
Hospital staffs throughout the state are becoming more attentive now to social factors that impact people’s health, said Dr. Mary Cooper, of the Connecticut Hospital Association: things like housing, transportation, food insecurity and the ability to understand discharge instructions. Increasingly, hospitals are working with community groups to connect patients with resources they need, she said.
This is going a step beyond the traditional idea of a hospital’s responsibility simply to maintain the best medical and sanitary conditions that it can. But if a new model of hospital care — one that takes more social factors into consideration — can improve patient care, surely that’s a good thing.
“The hospitals are asking to be partners with the patients,” Cooper said. “That’s a big change in culture. That’s really going to have a tremendous impact.”