A new report from the Empire Center for Public Policy indicates Elmira’s two hospitals are at opposite ends of the spectrum when it comes to patient re-admissions.
But hospital officials say that disparity in numbers has a lot to do with the populations of patients they treat.
The Albany-based think tank compiled federal data going back to 2012 tracking hospitals that are penalized by Medicare for re-admitting too many patients within 30 days of discharge — which is viewed as a sign of inadequate treatment or poorly planned release.
Under the Affordable Care Act, the worst performers can lose up to 3 percent of their Medicare fees.
Arnot Ogden Medical Center falls into that category and is in fact one of two hospitals statewide that received the highest possible Medicare penalty, said Bill Hammond, Empire Center director of health policy.
At the same time, St. Joseph’s Hospital in Elmira was among 14 facilities statewide that were not penalized at all.
“New York as a state has the highest re-admission rate of any state, and so that has shown signs of getting better, but the rest of the country is getting better, too, so we continue to be among the highest in the country,” Hammond said. “Our hospitals are not leading the way on this issue. We are bringing up the rear. Individually, some do much better than others. You have hospitals on both ends of the spectrum in your area.
“Hospitals that are really focused on infections will improve their re-admission rate,” he said. “They also have emphasis on discharge planning as people leave the hospital.”
Arnot Ogden Medical Center and St. Joseph’s Hospital are not only in the same community, but they are under the same corporate umbrella — Arnot Health.
But the report on re-admission percentages focuses only on a narrow list of conditions and treatments, including congestive heart failure, pneumonia, coronary artery bypass graft. and total knee and hip replacements, said Arnot Health spokesman Kenneth Roberts.
Those conditions make up the bulk of the patients included in the re-admission report, and the vast majority of those patients are treated at Arnot Ogden, he said.
There are sociological factors that account for the different re-admission rates as well, Roberts said.
“This is complicated by the fact that Arnot Ogden Medical Center, being an inner-city hospital, treats a very challenging population of patients,” he said. “Social determinants of health, which include housing and food insecurity, access to care due to transportation issues, and the inability to pay for medications, etc., all affect the rate of re-admission.
“In other words, patients facing challenges like these once discharged from the hospital are at a higher likelihood to be re-admitted due to medication non-compliance, nutrition issues — not adhering to low-salt diets, for example, in the case of patients with congestive heart failure — and other complicating factors,” Roberts said.
Roberts also pointed out the data used for the report is a few years old, and Arnot Ogden has made significant strides in cutting back on avoidable re-admission in recent times.
The improvement can be attributed to steps including providing follow-up appointments, ensuring a continuum of care from in-patient to out-patient, and more education with patients to ensure proper understanding of medications, among others.
“The decline in percentage of re-admission from 2014 to 2018 is about 12 percent for avoidable re-admissions,” Roberts said. “So while the data in the report showed a 3 percent penalty in the prior year, based on our more recent performance, our penalty will be dropping to 0.97 percent in the next period.”