Insurers, unions, consumer groups urge CMS to re-issue a rule on steering in the individual market and prohibit third-party premium assistance payments made by a financially-interested party.
An unlikely ad hoc group of insurers, businesses, unions, and consumer groups want the federal government to crack down on what they say is the inappropriate steering of Medicaid and Medicare-eligible patients with end stage renal disease into higher-paying commercial coverage.
The group said dialysis providers are "gaming" a provision in the Affordable Care Act that allows them to provide premium assistance for patients enrolled in Exchange plans through a "financially interested third party – the American Kidney Fund."
In exchange for the premium assistance, the dialysis providers collect higher reimbursements from commercial plans, even though the patients are Medicare- or Medicaid-eligible.
"What may appear to be innocent assistance to a patient, may in fact be an effort to change that individual’s coverage and caregiving in a way that benefits the third party or others, and not the patient," the ad hoc group said in a joint letter to Health and Human Services Secretary Alex Azar.
American Kidney Fund President and CEO LaVarne A. Burton said the letter to Azar is the latest shot in a long-term, coordinated "discrimination strategy against ESRD patients."
"It’s appalling," Burton said. "The real steering playbook is outlined in today’s letter spearheaded by insurers, employers and labor unions: let’s get these people off employer-provided insurance and let’s push them onto the government rolls whether that works for them or not."
The letter to Azar was signed by groups including America’s Health Insurance Plans, Blue Cross Blue Shield Association, Families USA, National Partnership for Women & Families, National Association of Wholesalers-Distributors, and Service Employees International Union.
The group has called on the Centers for Medicare & Medicaid Services to re-issue its rule on steering in the individual market and prohibit third-party payments made directly or indirectly by a financially-interested party. They also want policymakers to protect the employer market from inappropriate steering.
"This gaming of the Affordable Care Act’s guaranteed issue rules generates significant profit for dialysis providers engaged in these schemes. J.P. Morgan estimated that the return on 'charitable' donations by dialysis providers to the American Kidney Fund likely exceeds 500%," the letter said.
In 2016, J.P. Morgan reported that 6,400 Qualified Health Plans purchased through the AKF drove an estimated $1.7 billion in adverse selection. This steering into the employer market generates $450 million a year in operating income for one dialysis provider that the letter did not identify.
"When third parties with conflicts of interest and who gain financially intervene in the provision of health insurance benefits in a manner that changes the financial balance inherent in the relationship between payers and plan beneficiaries, to the detriment of the healthcare system, the results can be adverse for the individual being assisted, for other plan beneficiaries, and for the sustainability of commercial health plans as a whole," the letter said.
On Tuesday afternoon, AKF sent a rebuttal letter to Azar that accused the health plans, business groups, unions and consumer groups of "misleading statements, omissions, half-truths and outright falsehoods."
"The letter has one true purpose: to limit the health coverage options of people with kidney failure by forcing them off private insurance and onto government health programs," the AKF letter said.
AKF Responds
Here is Burton's entire statement:
"For years, if not decades, some very profitable business groups and health insurance providers have tried and pursued a discrimination strategy against ESRD patients. It’s appalling.
The real steering playbook is outlined in today’s letter spearheaded by insurers, employers and labor unions: let’s get these people off employer-provided insurance and let’s push them onto the government rolls whether that works for them or not.
Unfortunately, many times, only when people have a personal experience (family or friend) with ESRD do they realize the difficult health care decisions patients have to make. To the powerful groups that spearheaded this letter, ESRD patients are a cost that they want shifted elsewhere. To us, they are men, women, husbands, wives, mothers and fathers who deserve the dignity to have the health care that best suits their personal and family situation, even if they need charitable help to pay for it.
Our goal is to make health coverage possible for those who can least afford it when they get kidney disease. With very few exceptions, these are patients with little to no meaningful assets. Certainly not enough to afford health care without tremendous out-of-pocket costs. We help patients with any type of insurance plan they’ve chosen, public or private. It’s ironic that the same insurers who say all ESRD patients belong on Medicare are, at the same time, denying charitable premium assistance that allows Medicare patients to afford the Medigap plans that protect them from personal financial ruin.
These groups don’t understand what these patients experience. They just look at cost and say it should be someone else’s problem to bear.
Healthcare coverage cannot just be for healthy people. This letter should send a chill down the spine of every person with a chronic disease. Which disease will be rejected by insurers and employers for health coverage next--cancer, diabetes, obesity or asthma? Because they won’t just stop with kidney failure.
This outright discrimination against ESRD patients, who are disproportionately members of minority groups, has to stop. It’s a life and death situation, and like previous Administrations, Congresses and courts, we believe Secretary Azar will reject this cynical effort to deny health coverage to people who need it most."
Barriers that ACOs may face in shifting visits to PCPs 'could include low numbers of PCPs contracted in the ACO, and existing referral patterns and patient relationships with specialists.'
Primary care physicians are supposed to play a key role providing cost-effective care under the Medicare accountable care organization model.
However, anew studyfrom the University of Pittsburgh Graduate School of Public Health shows that a large proportion of Medicare ACO patients with chronic conditions skipped primary care management and evaluation consults and visited more expensive specialists instead.
"Many ACOs may underutilize PCPs, and thus could actively shift care to less expensive primary care for potential savings to payers," the study said.
The researchers analyzed data on 3.7 million visits to 219 ACOs by 1.1 million Medicare patients in 2013, one year after ACOs began under the Affordable Care Act. The patients had at least one of eight chronic conditions that can be managed by primary care, including: asthma, chronic kidney disease, chronic obstructive pulmonary disease, depression, diabetes, high cholesterol, high blood pressure, and osteoarthritis.
Study lead author Evan S. Cole, a researcher with the Graduate School of Public Health at the University of Pittsburgh, stressed that the study provides an "early look" at ACOs and that more recent data could show that care patterns have shifted toward primary care as ACOs mature and gain experience.
"Our study provided a snapshot of the distribution of visits for chronic conditions between primary care providers and specialists by ACO-attributed Medicare beneficiaries in 2013, and thus we cannot draw conclusions on whether that distribution shifted in any way in the following years," Cole said.
"I believe that is an important question to explore in future research and hope our study informs that research. I am personally not aware of other analyses that would indicate a shift towards or away from primary care for the management of chronic conditions within ACOs since 2013," he said.
The study found that:
On average, 61% of chronic condition evaluation and management visits were to PCPs. However, that figure varied across ACOs from 34% to 81%.
There was substantial variation by condition. PCPs accounted for most visits for hyperlipidemia, hypertension, and diabetes, but only 17.5% of visits for depression.
Demographics and health factors of the ACOs’ patient populations were associated with the proportion of PCP visits.
ACOs with a larger supply of specialists had lower proportions of visits for chronic conditions delivered by PCPs.
On average, about half of providers contracted to provide care for ACOs were PCPs in 2013, but that figure varied from 13% to 100%.
The share of visits for chronic conditions made to PCPs were higher at ACOs that had contracted with a higher proportion of PCPs.
Overall, patterns of chronic condition visits were similar for ACO-attributed patients compared to similar non-ACO Medicare beneficiaries.
The researchers stressed that the study provides an "early look" ACOs, and that more-recent data could show that care patterns have shifted toward primary care as ACOs mature and gain experience.
Medicare paid a total of $17.6 million in telehealth payments in 2015, compared with $61,302 in 2001, but a review found significant shortcomings in the documentation for the consultations.
More than half of the $13.8 million in Medicare telehealth payments examined by federal auditors fell short of reporting requirements.
Medicare telehealth payments include a fee paid to the clinician performing the service at a distant site, and an originating-site fee paid to the hospital or clinic where the patient receives the service.
However, the Department of Health and Human Services' Office of the Inspector General focused its audit on the more than 191,000 Medicare distant-site telehealth claims totaling $13.8 million and filed between 2014 and 1015 that did not have those required corresponding originating-site claims.
The auditors then reviewed a sampling of 100 of those incomplete telehealth claims and found that 31 did not meet reporting requirements.
Specifically:
24 claims were unallowable because the beneficiaries received services at non-rural originating sites;
7 claims were billed by ineligible institutional providers;
3 claims were for services provided to beneficiaries at unauthorized originating sites;
2 claims were for services provided by an unallowable means of communication;
1 claim was for a non-covered service;
1 claim was for services provided by a physician located outside the United States.
"We estimated that Medicare could have saved approximately $3.7 million during our audit period if practitioners had provided telehealth services in accordance with Medicare requirements," the auditors said.
OIG blamed CMS for the deficiencies, and said the agency failed to ensure that:
There was oversight to disallow payments for errors where telehealth claim edits could not be implemented;
All contractor claim edits were in place;
Clinicians were aware of Medicare telehealth requirements.
OIG recommended that CMS:
Conduct periodic post-payment reviews to disallow payments for errors for which telehealth claim edits cannot be implemented;
Work with Medicare contractors to implement all telehealth claim edits listed in the Medicare Claims Processing Manual;
Offer training sessions to clinicians on Medicare telehealth requirements.
New survey shows that while there is widespread agreement that risk-based population health models are here to stay, a growing number of healthcare providers are reluctant to take on the risk.
Many healthcare providers are reluctant to embrace risk-based population health models and are falling further behind the pace setters in this space, a new survey shows.
In their third annual survey, consultants Numerof & Associates queried more than 400 healthcare executives about their status risk-based population health models and found that:
Progress has fallen short of expectations. In the 2015 survey, 59% of respondents said they would be at least "very prepared" to take on risk in 2017. This year, 21% felt they had achieved that mark.
Risk-based contracts for organizations are mostly experimental. For 70% of respondents, lower than 20% reported revenue involvement.
Financial loss is a deterrent for taking on risk. 25% of respondents noted financial loss as a roadblock to adapting a more risk-based model.
Executives agree that population health is the future of healthcare. Respondents, on average, expect 15% revenue growth stemming from at-risk agreements over the next 2 years.
Cost and quality management is lacking. 58% of respondents rated their organization as average, or worse than average, when asked about their management in cost variation.
Numerof & Associates President Rita Numerof said virtually all healthcare providers believe that healthcare delivery is headed towards a risk-based, population health model, but that "a few leading organizations have separated themselves from the rest of the pack."
"The shift in the business model has proven difficult for many to achieve due to institutional hurdles and concerns over financial losses," Numerof said.
Numerof managing partner Michael Abrams said that at some point providers have to take the leap or risk falling even further behind.
"Hospitals that hedge their bets by experimenting at the margins with at-risk payment models underestimate the importance of moving up the experience curve," Abrams said. "Accountability for cost and quality is inevitable, and the sooner a commitment is made, the sooner the necessary competencies will be developed."
Survey collaborator David B. Nash, MD, dean of the Jefferson College of Population Health, said risk-bearing population health models have created "an apparent paradox in our country today."
"We want to improve health, but the numbers say that we are far short of previously stated goals," Nash said. "One is therefore forced to ask the question--what is the real mission of our industry at this key juncture?"
The retail pharmacy giant has the potential to be a game-changer in the highly concentrated, $34 billion kidney dialysis industry, using its ubiquitous retail presence to push consumers into home dialysis.
CVS Health's announcement that it will enter the kidney home dialysis market presents the company with as many challenges as opportunities, says industry analyst Jack Curran.
"The dialysis market right now is very concentrated," says Curran, a senior analyst with IBISWorld.
"If any company is going to be able to move into this industry and succeed it is going to have to be a large company with a lot of resources, like CVS," he said. "Right now, with their very heavy M&A activity, in trying to grow their healthcare offerings, CVS is probably going to be very well positioned to succeed."
The biggest challenge for CVS in the kidney dialysis market is its lack in-center dialysis. Fresenius Medical Care and DaVitacontrol about 95% of the in-center market, and Curran estimates that 8% or less of all dialyses occur in the home.
Nearly 700,000 people have end-stage renal disease, and nearly 500,000 of these patients are on active dialysis and more than 120,000 new ESRD cases are diagnosed each year.
Medicare spends nearly $34 billion each year on dialysis patient care.
Bruce Culleton, MD, CMO at CVS Specialty, says the high costs of dialysis are not reflected in the outcomes, noting that mortality rates for Medicare patients treated with in-center hemodialysis are up to 10 times higher than among the general Medicare population.
"While in-center dialysis clinics are currently the most common choice for hemodialysis treatment, published clinical research has shown improved cardiac health, metabolic control, and survival for patients who are treated with longer, more frequent dialysis treatments. This treatment paradigm is best delivered in the convenience of a patient's home," Culleton said.
"CVS Health is uniquely positioned to build a solution that will enable us to identify and intervene earlier with patients to optimize the management of chronic kidney disease, while at the same time making home dialysis therapies a real option for more patients," he said.
Curran says that CVS will be challenged to convince dialysis patients to stay at home.
"It comes down to consumer preference," he says. "People feel more comfortable going into a center where they know they have someone skilled who can handle it. To do home dialysis you have to go through about one month of training. So, it’s a big time investment to do home dialysis."
However, a big player such as CVS with its massive retail presence could change consumer views about home dialysis.
"When you have patients going into CVS clinics and learning about their home dialysis options, if CVS is telling them one of their options is home dialysis, they are likely going to look into it," he said.
In addition, CVS could be poised to take control of the home dialysis market because Fresenius and DaVita are in-clinic centric "so they’re not going to push for home dialysis, even close to as much as a company like CVS would do when they are only offering it," Curran says.
Curran says it will be telling to see who CVS choses to partner with when it comes into the home dialysis market.
"They haven't said what company they’re going to be working with, or who will manufacture their home dialysis device," he says. "The dialysis home equipment industry is also very concentrated. It may depend on the resources of that company and how well-positioned they are to produce a product that is going to be able to compete with Fresenius and Baxter’s devices."
Curran says there are rumors that CVS could work with Baxter, the nation's largest home dialysis equipment manufacturer. "I haven’t seen anything confirmed," he said, "but if that is the case, it's going to be a huge opportunity that could set them apart."
For Curran, who CVS partners with will speak volumes.
"If it's a bigger manufacturer, that is a sign that they are going to do well," he says. "If it's a smaller company that hasn't worked with dialysis equipment that is going to be a challenge. Because of the high concentration in the dialysis equipment manufacturing industry, it's going to be a lot more competitive to get products out."
Even though the dialysis market is highly concentrated, Curran says CVS could still shake things up for established players such as DaVita and Fresenius.
"If CVS's entering this market increases demand for in-home dialysis, then these companies may emphasis their in-home dialysis services," he says. "And meanwhile, they may also push the fact that they have in-center dialysis, as a way of saying that we are able to offer more than CVS, or that they can provide different options."
Compared to physicians who receive no money, those who were paid for meals and lodging from drug makers had higher odds of prescribing that company's cancer drugs.
Physicians who accepted money from drug companies for meals, talks, and travel were more likely to prescribe those companies’ drugs for two cancer types, a new study in JAMA Internal Medicineshows.
"The main takeaway is that oncologists who received money from a pharmaceutical company were more likely to choose that company's drug the following year," said study lead author Aaron Mitchell, MD, a fellow in the UNC School of Medicine Division of Hematology & Oncology.
Researchers analyzed prescriptions for Medicare patients with two cancers where there are multiple treatment options: metastatic renal cell cancer, and chronic myeloid leukemia.
"We wanted to look at cancer types for which there were several similar medications to choose from," Mitchell said. "Further, we wanted to look at cancer types where the different treatments would all be considered as 'standard of care' based on FDA approval and NCCN recommendation. RCC and CML and the associated drug sets best met these criteria.
They used publicly available data from 2013 to 2014 that was reported through Open Payments, a provision of the federal Patient Protection and Affordable Care Act that required drug makers to disclose gifts or transfers in value greater than $10 to physicians and teaching hospitals.
Compared to physicians who received no money, those who were paid for meals and lodging from a drug maker had higher odds of prescribing that company's drug for metastatic renal cell carcinoma and for chronic myeloid leukemia.
For metastatic renal cell cancer, physicians who received any payment in 2013 had twice the odds of prescribing that company's drug, and for chronic myeloid leukemia physicians who received any general payment had 29% higher odds of prescribing that company's drug.
A review of specific drugs found a significant decrease in the use of the leukemia treatment imatinib when physicians received payments. Novartis makes both imatinib and another treatment, nilotinib.
Since imatinib was about to lose its patent protection, the authors said the finding suggests that payments were done in the hope of "switching" physicians from the older drug imatinib to the newer drug nilotinib.
Mitchell said the "proof-of-principle" study was designed to see if there was a link between industry payments and the cancer drug prescriptions, but he cautioned that it does not show a cause-and-effect relationship, and that the payments are not improper.
"Industry payments to physicians are entirely above-board and legal," he said. "Whether they are unethical is an area of ongoing debate in the medical community, which different physicians would disagree about."
"None of these drugs would be considered more effective than the other as based on FDA approval and recommendation by the NCCN," he said. "Furthermore, if a medication's use were due to it being more effective, then we would expect to see higher use of that drug among all physicians, with no difference between those who did and did not receive money from the drug's manufacturer."
Mitchell said he can't say if the influence of the drug industry affects a broad array of drugs beyond the ones examined in the study, but "we think this is a worthwhile question."
"In terms of other areas of medical practice besides oncology, other researchers have suggested that this may be quite ubiquitous," he said. "Similar associations have been found for blood pressure drugs, cholesterol drugs, anti-depressants, and others."
Mitchell said it is the responsibility of each physician to decide whether they want to enter a financial relationship with the drug industry, and that of the patient to decide whether this information will influence their choice of physician.
"As this potential problem gets increasingly recognized, I would look toward physician professional societies and patient advocacy groups to raise awareness and call for more transparent and restrained behavior on the part of physicians," Mitchell said.
"Many academic institutions and medical centers have instituted conflict-of-interest policies in order to manage any real or perceived bias from physician-industry relationships, though this is by no means universal."
Researchers urge newly merged health systems to address patient risks, share data on quality and safety, and clearly define care oversight responsibility for the joint patient population.
Healthcare mergers and acquisitions could adversely effect patient safety as clinicians deal with changes in their practice setting, patient mix, and infrastructure, a JAMA study has found.
Researchers at Harvard University analyzed the patient safety risks for Harvard-affiliated institutions by speaking with clinicians and health system leaders. Their interviews uncovered three oft-unrecognized areas of "significant safety risks" that are linked to changes in patient populations, infrastructure, or clinician practice settings.
"Teams with little expertise in patient safety are typically responsible for implementing health care mergers, acquisitions, and affiliations," the study said. "Their primary impetus is often financial rather than clinical, and when the impetus is clinical, the concerns usually involve patient access and services rather than the way care is practiced in the affected institutions."
Because of that emphasis, the responsibilities for quality and safety are often unclear.
"As a result, risks to patients arise at the 'sharp end' of care, where clinicians are asked to practice in new settings, with new populations, or with new infrastructure, without sufficient planning," the study said.
New patient populations
After a merger, acquisition or expansion, health systems may experience changes in volume and demographics with patient populations.
While hospitals do a good job anticipating the needs of these new patient demographics or clinical services at the unit level, they may lag in ensuring that staff throughout the hospital are able to interact with these new patients.
"An increase in referrals may bring an influx of non–English-speaking patients, for instance, who require more interpreters, institutional relationships with different community services, and increased awareness of economic and social challenges these patients face in following care guidelines," the report said.
That lack of wider institutional attention to specialized needs can result in serious deficiencies in provision of safe, timely care, the report said.
Unfamiliar infrastructure
The researchers note that health system expansions and mergers often come with significant changes in supplies, equipment, formularies, protocols and electronic information systems, all of which can create a significant learning curve for clinicians.
"The attention clinicians must now give to once 'automatic' tasks also distracts from other aspects of patient care or slows throughput," the study said. "Unless schedules and capacity are adjusted, such shifts in time and focus not only may result in dissatisfied patients but also in increased likelihood of major errors."
New clinical settings for physicians
A survey of 82 healthcare institutions that have undergone expansions found that 87% require physicians, especially specialists, to travel to new practice sites.
"When clinicians travel, they often receive little systematic orientation to their new setting, leaving them to practice with infrastructure, processes, teams, and a clinical culture that can vary in significant and unexpected ways from those at their home institutions," the study said.
“In the absence of guidance, physicians indicated that they have adapted to these new circumstances through trial and error, which can put patients at risk."
The study offers some risk mitigation strategies, such as: providing "hands-on orientation" for new physicians about institution-specific emergency resources; and identifying all hospital units that may care for new patient populations but are not in the direct care path.
A federal judge says that Blue Cross Blue Shield's 'aggregation of competitive restraints' represent a per se violation of anti-trust laws. BCBS will appeal the ruling.
A federal judge in Alabama has ruled that agreements among Blue Cross Blue Shield companies across the nation to carve out markets and limit competition will be reviewed as inherent violations of the Sherman Anti-Trust Act.
U.S. District Judge David R. Proctor on Thursday ruledthat the "plaintiffs have presented evidence of an aggregation of competitive restraints…which, considered together, constitute a per se violationof the Sherman Act."
The granting of the plaintiffs' motion for partial summary judgment is the latest step in a five-year-long legal battle in federal court in Birmingham.
A Blue Cross Blue Shield Association attorney said the health insurer would appeal the ruling, which he called "one step in a lengthy process."
The plaintiffs, who include a class of BCBS customers, allege that the 36 Blue Cross Blue Shield companies have entered non-compete pacts that allocates the markets in which they sell health insurance and caps the amount of unbranded health insurance they offer.
The suit claims that the pact artificially inflates premiums and decreased consumer choice for health insurance.
"Our case alleges that, for decades, the Blue Cross Blue Shield system has operated as an illegal association of competitors trying to suppress competition in order to inflate their own profits at the expense of their customers," said Michael D. Hausfeld, lead counsel for the plaintiffs.
"We look forward to taking our case to trial and achieving a nationwide injunction to stop these practices once and for all," he said.
Scott Nehs, general counsel for the Blue Cross Blue Shield Association said he is confident that the insurers will win their appeal.
"The District Court stated that it is constrained by authority from the late 1960s and early 1970s, which we believe is inapplicable for a number of reasons," Nehs said. "The Blue Cross and Blue Shield System has served Americans well for almost a century, and we are disappointed by the court’s ruling with respect to certain aspects of the BCBS System."
Nehs said that the ongoing litigation will not affect operations for Blue Cross Blue Shield companies or their more than 106 million customers and healthcare providers.
"The BCBS System enables members to receive in-network medical care everywhere in the country and has substantial competitive benefits for consumers and medical professionals," he said
The American Hospital Association says the recommendation comes as hospitals are already grappling with record-low negative Medicare margins for services.
The Medicare Payment Advisory Commission (MedPAC) is calling for a big payment rate cut for some freestanding emergency departments.
The panel on Thursday unanimously recommended that "Congress should reduce Type A emergency department payment rates by 30% for off-campus stand-alone emergency departments that are within six miles of an on-campus hospital emergency department."
Like everything else with the nonpartisan MedPAC, recommendations are non-binding, and Congress is free to adopt the recommendations or ignore them.
The American Hospital Association (AHA) has come out as strongly opposed to the cuts in comments submitted to MedPAC. AHA said the recommendation "is not based on any analysis of Medicare beneficiaries, Medicare costs or Medicare payments and would make Medicare’s record underpayment of outpatient departments and hospitals even worse."
AHA said that Medicare margins were a record-low negative 14.8% for hospital outpatient departments and negative 9.6% for hospitals overall in 2016, with the latter expected to reach negative 11% this year.
At the same time, AHA said it supports a recommendation to allow isolated rural hospitals to convert to stand-alone EDs, and urged MedPAC to include EDs in vulnerable urban communities as well.
The action comes as hospital and Colorado public health officials continue their investigation of contaminated surgical equipment that could have exposed patients to HIV and hepatitis.
Acting on "an abundance of caution," Porter Adventist Hospital in Denver said Thursday it will temporarily suspend all surgeries at the hospital until it corrects water quality issues that could be linked to contaminated surgical equipment.
The suspension comes one day after the hospital sent notices to orthopedic surgery patients warning of a potential risk for infection from improperly cleaned surgical equipment. That breach is still under investigation, and it was not immediately clear if the contaminated water was the source of the breach.
"We made the decision to pause all surgeries after we noticed a potential change in our water quality relative to our surgical equipment," Porter Adventist said in a written statement.
"We are working closely with patients to reschedule surgeries, and we are supporting them through this process. We notified the Colorado Department of Public Health & Environment and they conducted a site visit on April 5."
On Wednesday, orthopedic and spine surgery patients treated at the hospital between July 21, 2016 to Feb. 20, 2018 were notified that they could have been exposed to surgical site infections for hepatitis B, hepatitis C or HIV.
It has not been made clear how many patients may have been exposed to potential infection, but Colorado public health officials said they are not aware of any patient infections related to the breach.
Porter Adventist said it is offering patients who underwent orthopedic or spine surgical procedures from February 21, 2018 to April 5, 2018 the opportunity to be tested for bloodborne pathogens.
"We will be notifying these patients directly via a written letter and will be providing additional information regarding surgical site infection," a statement from the hospital read. "As always, we are committed to patient safety and supporting them through this process."
"We recognize this news follows Wednesday’s announcement about a past gap in the pre-cleaning process of surgical instruments, prior to manual washing, machine washing, and sterilization," Porter Adventist said. "We continue to maintain that the risk of infection to patients is extremely low."
"We remain committed to maintaining the highest standards of patient care," the hospital statement read. "We understand that this information may cause concern, and are working closely with our patient care team, doctors and staff to ensure any patients involved have the information and resources they need."
The state health department was notified of the breach Feb. 21. The department conducted an on-site survey of infection control practices at the hospital. A disease control investigation is ongoing.
The department last visited the hospital March 28, confirming that current infection-control practices meet standards.
Porter Adventist stopped using and reprocessed all surgical equipment in question Feb. 20.
