Happy Thanksgiving - Thank You to Connecticut's Hospitals and Caregivers

As Thanksgiving nears and we pause to celebrate our many blessings, we extend our thanks to all those who make caring for Connecticut’s patients their life’s work.  We are honored to stand in solidarity with you during this difficult time and to support your efforts to improve the lives of patients.  We wish you and your families a happy and safe Thanksgiving. 


Advocacy Campaign Continues as Budget Negotiations Heat Up at Capitol

Governor Malloy and state lawmakers from both parties released their plans this week for closing the state’s $350 million budget deficit, demonstrating the need for Connecticut hospitals to continue their advocacy efforts at the state Capitol.

The Governor’s plan calls for $350 million in cuts that will primarily impact social services, municipal aid, and education.  He would not restore any of the funds cut in his September 18 rescissions, and his proposal includes a $50 million reduction in payments to hospitals, which equals the remainder of the supplemental payments owed to hospitals for the quarter ending on September 30. The Governor also called for cutting $1.5 million from Community Care Teams, a new program embraced by hospitals and supported by lawmakers for its ability to serve the mental health needs of some of the state’s most vulnerable people.

Democratic lawmakers, who will caucus again tomorrow (Friday), released a budget reduction plan that finds $350 million in savings through a combination of cuts to the Judicial branch, public safety, the prison system, cultural and tourism programs, and legislative management. It proposes to restore $34 million in hospital funding that was rescinded by Governor Malloy in September. Combined with federal reimbursements, this amounts to a $102 million proposed funding restoration to hospitals.  Democrats have not specified how the funds would be distributed.

Republican leaders also announced a plan for addressing the budget deficit, but their proposal did not make any cuts to hospitals, Medicaid, or services for those needing mental health or substance abuse treatment. Instead, the GOP called for $372.8 million in savings reached through a variety of cuts, including restrictions on labor costs, bonding limitations, and canceling a $94.6 million payment to a municipal fund.

In light of the shifting nature of the budget negotiations, and the deepening fiscal problems facing Connecticut, CHA remains committed to the Stop The Cuts Now campaign, calling on Governor Malloy to reverse his cuts to hospitals.  

We ask that you sign the petition linked here, join our electronic letter-writing campaign to legislators by clicking here, and follow us on Facebook and Twitter.



Getting Smart About Antibiotics Can Save Lives

This week is the Centers for Disease Control and Prevention’s Get Smart About Antibiotics Week, an annual observance to raise awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic prescribing and use.

Connecticut hospitals view antimicrobial stewardship as important for medical care quality, and many have antibiotic stewardship programs in place led by physician champions, are tracking and controlling antibiotic use, and offer provider education.

Antibiotic resistance is considered one of the most important infectious disease threats of our time. Already more than two million people in the United States get infections that are resistant to antibiotics every year – and at least 23,000 people die as a result.  If hospitals were to lose the ability to use antibiotics, we would also undermine our ability to treat patients with sepsis, cancer, provide organ transplants, and save victims of burns and trauma.

The American Hospital Association’s Physician Leadership Forum offers a toolkit that includes resources for hospitals, clinicians, and patients.


CMS Launches New Payment Model for Joint Replacements

According to the Centers for Medicare & Medicaid Services (CMS) final rule issued Tuesday, November 17, CMS payments to hospitals for hip and knee replacement surgery will be linked to the quality and cost of the surgery starting on April 1, 2016.

Under the new pilot program, hospitals where joint replacements take place will be held accountable for both the outcomes and costs of these surgeries, from the time of the operation through 90 days after discharge.  Hip and knee replacements are the most common inpatient surgery under the Medicare program, which paid for 400,000 of these operations last year.

In a statement, AHA President and CEO Rick Pollack said the rule “takes several positive steps to provide the support hospitals need to be successful” as they redesign the way care is delivered to increase value and better serve patients.

CMS will use a retroactive payment methodology with one-sided risk in the first year of the program – meaning no hospital will be penalized in year one – and two-sided risk in subsequent years.  Although AHA’s request that the program be limited to elective surgeries only was not adopted by CMS, the agency did agree to stratify risk based on a beneficiary’s hip fracture status.

According to CMS, the cost of joint replacements ranged in cost from $16,500 to $33,000 across the nation, with different rates of success at some hospitals than others.  The new payment model is intended to encourage accountability across the healthcare system, meaning that hospitals can receive more federal funding by meeting specific goals tied to quality and cost and can be financially liable if they fall short.

CMS finalized the Comprehensive Care and Joint Replacement payment model on November 17.  The program is scheduled to conclude Dec. 31, 2020.


Becker's Hospital Review Recognizes Elliot Joseph and Marna Borgstrom

Elliot Joseph, President and CEO of Hartford HealthCare, and Marna Borgstrom, President and CEO of Yale New Haven Health, have been named by Becker’s Hospital Review as two of its “130 Nonprofit Hospital and Health System CEOs to Know.”

The list features presidents and CEOs across the country working in healthcare’s not-for-profit sector.

Ms. Borgstrom began her career at Yale-New Haven Hospital over 36 years ago.  Her varied roles took her from a post-graduate fellowship, to various staff and management roles, to her promotion in 1994 to the position of Executive Vice President and Chief Operating Officer at Yale-New Haven Hospital.  In 2005, she assumed her current position as CEO of Yale-New Haven Hospital and President and CEO of Yale New Haven Health.  Yale New Haven Health includes Bridgeport, Greenwich, and Yale-New Haven Hospitals, and a physician foundation, Northeast Medical Group.  Yale-New Haven Hospital, which acquired the 540-bed Hospital of Saint Raphael in 2012, is the 1,541-bed primary teaching hospital for the Yale School of Medicine.

In addition to leading Yale New Haven Health, Ms. Borgstrom Chairs the boards of NewCo (the merger of the newly formed VHA, Inc., and University Health System Consortium, the largest member-owned healthcare company in the country) and the Coalition to Protect America’s Healthcare in Washington, DC. She also serves on the Boards of the Healthcare Institute and the Connecticut Hospital Association.  Ms. Borgstrom has been the recipient of several awards recognizing her advocacy and community involvement including the American Hospital Association Grassroots Champion Award and the Anti-Defamation League Torch of Liberty Award.  She was named twice to Modern Healthcare Magazine’s Top 25 Women in Healthcare.  She is an American College of Healthcare Executives fellow.

Mr. Joseph came to Hartford Hospital in 2008 as President and CEO.  Over the course of three decades, Mr. Joseph has been a champion for a more efficient, high quality healthcare system.  Under his leadership, all Hartford HealthCare member organizations are driven by clear, measurable goals and metrics.  His vision for Hartford HealthCare has focused on integrating the care continuum to produce consistently excellent and affordable healthcare for all, especially the poorest and most vulnerable citizens.

Prior to his arrival in Hartford, Mr. Joseph was president and CEO of St. John Health (SJH), a $1.8-billion southeast Michigan healthcare system.  Mr. Joseph is a member on the Connecticut Hospital Association Board of Trustees and chairs the CHA Committee on Hospital Finance.  He also is a member of the Greater New York Hospital Association Board of Governors.  He serves as the American Hospital Association State Alternate Delegate and is a member of Regional Policy Board 1.  He also serves on the boards of the Metro Hartford Alliance and Hartford’s Bushnell Performing Arts Center.  He recently was named one of Hartford’s “50 Most Influential People.” 

Becker's Hospital Review began publishing “130 Nonprofit Hospital and Health System CEOs to Know” in 2012.  Leaders were selected based on editorial judgment and discretion.  The full list features individual profiles of all 130 hospital and health system executives. The full list can be read here.


Education Updates

HRO Leadership Method Training
Tuesday, December 1, 2015
9:00 a.m. - 4:00 p.m.
Event Registration

Leadership training is for organizations that are new to high reliability or for new management employees in organizations that are already on the high reliability journey. Both hospital and ambulatory organization leadership practices will be addressed. The seven-hour Leadership sessions are designed to teach hospital or ambulatory leaders the concepts of high reliability science and behaviors. The sessions are structured for leaders at the manager level and above.

Medicine, Nursing, Quality, and Radiology continuing education credits are offered for this session.


HRO Safety Coach Training
Wednesday, December 2, 2015
9:00 a.m. - 12:00 p.m.
Event Registration

Safety Coaches are peer mentors, designed to recognize and acknowledge good high reliability behavior and to remind people about opportunities to improve behavior that does not stay true to high reliability concepts.

Medicine, Nursing, and Quality continuing education credits are offered for this session.


HRO Fair and Just Accountability
Wednesday, December 2, 2015
1:00 p.m. - 4:00 p.m.
Event Registration

Fair and Just Accountability is a session for Human Resources Executives and anyone else who manages people. This session trains staff to review performance from a standardized perspective when there is an adverse event.  It teaches them to focus on the behavior rather than the outcome.

Medicine, Nursing, and Quality continuing education credits are offered for this session.


HRO Safety Event Classification
Thursday, December 3, 2015
10:00 a.m. - 4:30 p.m.
Event Registration

When events occur in the hospital or ambulatory practice, they must be evaluated to assess whether the event is a Serious Safety Event, a Precursor Safety Event, or a Near Miss Safety Event. This session will review how the classification scheme works and how to utilize and standardize event classification.

Medicine, Nursing, and Quality continuing education credits are offered for this session.


Physician Engagement Webinar
Thursday, December 3, 2015
12:00 p.m. - 1:00 p.m.
Event Registration

Steve Tremain, MD, from Cynosure will present this webinar.

The program is being presented as part of the Partnership for Patients HEN 2.0 educational series.


HIPAA Privacy and Security Basics
Friday, December 4, 2015
9:00 a.m. - 2:30 p.m.
View Brochure | Event Registration

This program will review the current HIPAA Privacy, Security, and Breach Rules, with an emphasis on recent enforcement actions by the Office for Civil Rights and an overview of the newly announced government audit targeting HIPAA compliance. The program information includes strategies for maintaining continuous compliance, a review of business associates rules, and practical tips and solutions for remaining compliant with HIPAA as the transition from paper to EHR accelerates. We will also cover emerging issues in privacy liability, including costs associated with breach events and a new Connecticut Supreme Court case that is likely to increase liability and risk for HIPAA-covered entities.

Continuing education credits will be awarded.  Please see the brochure for more details.


Basics of Budgeting for Healthcare Managers
Tuesday, December 8, 2015
9:00 a.m. - 3:00 p.m.
View Brochure | Event Registration

Many healthcare department managers have traditionally risen from the professional ranks as successful clinicians or technicians but with little or no formal business financial training. As a result, many are thrust into a chaotic environment without the necessary tools in financial management.  Skills in planning and budgeting are essential if they are to achieve the institution’s mission and contribute to “bottom line” results, particularly in an environment of chronic federal and state underfunding. In a very real sense, these represent survival skills for both managers and organizations. 

This member-requested management development program provides managers with the skills and tools they need to prepare better budgets, identify problems and solutions, achieve the mission, and succeed in today’s volatile healthcare environment. Participants will gain a working knowledge of operating and capital budgets, as part of developing performance planning skills.

Continuing education credits will be awarded.  Please see the brochure for more details.


Choosing Wisely: Vanderbilt’s Experience 
Wednesday, December 9, 2015
8:00 a.m. - 10:00 a.m.
View Brochure | Event Registration

Choosing Wisely is an initiative of the American Board of Internal Medicine (ABIM) Foundation to address the overuse of tests and procedures, and support physician efforts to help patients make smart and effective care choices. The initiative focuses on promoting patient-provider conversations that lead patients to select care that is necessary (neither duplicative nor overutilized), evidence-based, and not harmful. Many specialty societies—from common specialties such as the American College of Physicians and the American College of Radiology, to less common groups such as the American Society of Echocardiography and the American College of Medical Toxicology—have joined with ABIM and its campaign partner, Consumer Reports, to create lists of recommendations and questions that doctors and patients should discuss. Vanderbilt University Medical Center has been implementing Choosing Wisely recommendations on select inpatient services engaging staff, from first-year residents to senior hospital leaders. Our guests from Vanderbilt will provide an overview of their experience including successes, challenges, and outcomes.

This program is being held in partnership with Middlesex Hospital, the Connecticut Choosing Wisely Collaborative, Qualidigm, and the Connecticut Partnership for Patient Safety.


Approaches to Palliative Care 
Tuesday, December 15, 2015
9:00 a.m. - 4:00 p.m.
Event Registration

Unplanned readmissions remain a problem in Connecticut and our first program will address unplanned readmissions by addressing palliative care in the hospitals. The program Approaches to Palliative Care will be held at CHA from 9:00 a.m. to 4:00 p.m. on Tuesday, December 15, 2015. Our keynote speaker is Rosemary Gibson, who was the chief architect of the Robert Wood Johnson Foundation’s decade-long strategy that successfully established palliative care in more than 1,600 hospitals in the U.S. She is the recipient of the Lifetime Achievement Award from the American Academy of Hospice and Palliative Medicine. She will be followed by a panel highlighting the palliative care programs at Hartford Hospital, Greenwich Hospital, and Danbury Hospital. After lunch, we will have a workshop to teach people how to introduce palliative care when there is no formal program in the hospital. 

The program is being presented as part of the Partnership for Patients HEN 2.0 educational series.


VTE/DVT Webinar
Wednesday, December 16, 2015
12:00 p.m. -  1:30 p.m.
Event Registration

CHA will host a VTE/DVT webinar on Wednesday, December 16, 2015, from 12:00 p.m. to 1:30 p.m. Ian Jenkins, MD, an expert in VTE/DVT prevention, visited a number of hospitals during HEN 1.0 and will discuss approaches to use to bring down the incidence of VTE/DVT in hospitals.

The program is being presented as part of the Partnership for Patients HEN 2.0 educational series.


Changes in CPT/HCPCS for 2016
Wednesday, December 16, 2015
9:00 a.m. - 12:15 p.m.
View Brochure | Event Registration

CPT and HCPCS codes are the primary codes that describe individual hospital services that are billed to all payers. These code sets are revised annually with codes that are added, deleted, or revised. This workshop will focus on the 140 new, 134 revised, and 91 deleted CPT codes—including all major changes by body system, changes in diagnostic imaging, radiation oncology, and laboratory, plus additional bundling of procedures that are often performed together as well as new and revised coding guidelines. The workshop will also cover all changes to the HCPCS code set which is maintained by CMS. Each program participant will receive a comprehensive manual that outlines all the key code changes in 2016.

Continuing education credits will be awarded.  Please see the brochure for more details.

OPPS Final Rule for 2016
Wednesday, December 16, 2015
1:00 p.m. - 4:15 p.m.
View Brochure | Event Registration

The Centers for Medicare and Medicaid Services (CMS) has published the Outpatient Prospective Payment System (OPPS) Final Rule for 2016. The 2016 OPPS Proposed Rule contained a drastic increase in the number of services that will be classified as comprehensive APCs which will dramatically increase Medicare’s packaging of supportive services. Overall OPPS payments are proposed to drop by 1.9% for the first time in the history of OPPS. This workshop will cover how these changes impact hospital reimbursement and help to underscore the need for capturing all reportable costs. As always, billing compliance will be an important part of the presentation.

Each program participant will receive a comprehensive manual that outlines the final changes for 2016.

Continuing education credits will be awarded.  Please see the brochure for more details.