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Community Memorial Hospital in Hamilton received the second-largest Medicare pay increase in all of New York state, at 0.41 percent per Medicare patient.

Comparatively, all other Mohawk Valley hospitals—including Mary Imogene Bassett Hospital which umbrellas the Little Falls Hospital branch—Rome Memorial Hospital, St. Elizabeth Medical Center, Oneida Healthcare Center and Faxton St. Luke’s Healthcare—received pay cuts.

“We are very proud. I am very proud of the individuals here,” said Sean Fadale, president and CEO of Community Memorial Hospital. “The employees here and the medical staff take the responsibility for delivering excellent care. We take excellent patient satisfaction very, very seriously.”

The percentage increase or decrease in Medicare assistance each hospital will receive began on Jan. 1 under a new payment system. The hospital value-based purchasing program under The Affordable Care Act, also known as “Obamacare,” rewards or penalizes hospitals based on quality of service.

Under the hospital value-based purchasing program, every hospital’s payments were cut by 1 percent, totaling about $964 million. Medicare then distributed a percentage of that back to each hospital based on its performance.

Each hospital’s percentage is weighted 70 percent by how well it follows 12 clinical guidelines, and 30 percent by patient satisfaction surveys. These numbers will be recalculated on a yearly basis.

Under this program, Medicare compared nearly 3,000 hospitals nationwide on their performance adhering to standards of care, as well as a patient survey asking each person to rate his or her stay.

Mohawk Valley numbers

Based on this system, Medicare determined a 0.13 percent decrease for Mary Imogene Bassett Hospital; a 0.67 percent decrease for Rome Memorial Hospital; a 0.81 percent decrease for St. Elizabeth Medical Center, a 1.09 percent decrease for Oneida Healthcare Center and a 1.16 percent decrease for Faxton St. Luke’s Healthcare in Utica.

“These types of cuts in reimbursement have a significant impact on our organization,” said FSLH Vice President of Communications and Marketing Debra Altdoerffer.

According to Altdoerffer, FSLH will lose $75,000 in Medicare payments and $300,000 due to readmissions.

Of the above mentioned, Community Memorial consistently received higher percentages of satisfied patients.

“With healthcare reform moving forward, paying for performance is going to become the norm. Just because we scored well this first time around does not mean we are resting on our laurels. We are going to continue to work hard to improve our outcomes and our patients’ experiences,” Fadale said.

FSLH remained at the lower end of percentages, with the rest falling somewhere in between.

“FSLH has processes in place to consistently review the measures of care imposed by Medicare to make sure we are providing our patients and residents with safe, quality care as well as accurately documenting their care. We continue to work to meet the appropriate standards so we can avoid cuts in our Medicare payments,” said Altdoerffer.

Tough criteria

The survey asked patients to rate aspects such as communication, length of wait, control of pain, cleanliness, noise level and if they would recommend the hospital to others. Eighty-two percent of patients said they would recommend Community Memorial, whereas only 57 percent said they would recommend Rome Memorial.

“I think the main reason [we earned an increase] is because we pay attention to it. That’s not to say other organizations in the region don’t pay attention to it, but it is ingrained in what we do every day,” said Fadale.

On a national level, Medicare is rewarding 1,557 hospitals with pay increases and cutting payments to 1,427 low-scoring hospitals. Payments for about two-thirds of the hospitals change by less than a quarter of a percent, but for most hospitals Medicare patients make up the majority of their business. Therefore, hundreds of thousands of dollars are at stake.

For example, Medicaid and Medicare represent two-thirds of revenue for FSLH, according to Altdoerffer.

“Of note, our area also has a higher percentage of Medicare patients compared to other regions, which means hospitals in our region see more Medicare patients and can be more severely impacted when the cuts occur,” Altdoerffer said.

According to the data provided by Kaiser Health News, New York state hospitals are among the worst in the United States, accompanied by District of Columbia, Connecticut, Wyoming and Delaware. Hospitals in Maine, Nebraska, South Dakota, Utah and South Carolina fared the best.

Compared to the national averages, New York state hospital patients are generally 5.8 percent less satisfied with their level of care.

“The bar is being raised all around and everyone is realizing there is a scorecard now. Everyone is going to be working very hard to achieve those high marks,” Fadale said.

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