Issue link: https://beckershealthcare.uberflip.com/i/1311160
38 QUALITY IMPROVEMENT & MEASUREMENT Heart surgeons with less experience have worse valve surgery outcomes, study finds By Erica Carbajal E arly-career cardiac surgeons with less than 10 years of experience had worse patient outcomes for valve procedures than those with more than 10 years of clinical practice, according to a Nov. 3 study published in JAMA Network Open. Using data from the New York State Cardiac Data Reporting System, researchers analyzed coronary artery bypass grafting and valve procedure outcomes across 38 cardiac surgery centers in the state between 2014 and 2016. Participating surgeons included 120 who performed CABG and 112 who completed valve procedures for 39,436 and 18,596 patients, respec- tively. Data was analyzed in April 2020. Surgeons with less than 10 years of practice had a higher median risk-adjusted mortality rate of 4.0 for valve procedures compared to 2.8 for those with more than 10 years of experience. Researchers did not find a statistically significant dif- ference in risk for CABG procedures between those performed by surgeons with more or less experience, suggesting that additional valve surgery training is needed in residency programs and that CABGs are adequately addressed. n CMS fines 2,545 hospitals for high readmissions: 5 things to know By Ayla Ellison I n fiscal year 2021, CMS will penalize 2,545 hospitals for having too many Medicare patients readmitted within 30 days, accord- ing to federal data cited by Kaiser Health News. This is the ninth year of the Hospital Readmission Reduction Program. To determine penalties for fiscal 2021, CMS examined hospitals' 30-day readmission rates for patients who had original- ly been treated for the following conditions: heart failure, heart attack, pneumonia, chronic obstructive pulmonary disease, hip or knee replacement, and coronary artery bypass graft surgery. CMS used patient data from July 2016 through June 2019 to determine the penalties. The agency compared each hospital's reported readmission rate to national averages for each of the con- ditions to determine the penalties. Here are five takeaways from the Nov. 2 Kaiser Health News analysis: 1. Eighty-three percent of the 3,080 hospitals evaluated received a penalty. 2. CMS will cut payments to the penalized hospitals by as much as 3 percent for each Medicare case during fiscal 2021, which runs Oct. 1, 2020, through September 2021. 3. Thirty-nine hospitals were hit with the maximum penalty for fiscal 2021, down from 56 hospitals in fiscal 2020. 4. The average penalty will be a 0.69 percent payment cut for each Medicare patient. 5. Of the 3,080 hospitals evaluated, 613 will receive a penalty of 1 percent or more. n COVID-19 viral load may predict patient outcomes, study suggests By Erica Carbajal H ospitalized COVID-19 patients who had a high viral load early in their illness were nearly twice as likely to die or be intubated, according to a study published in Annals of the American Thoracic Society. Researchers analyzed records from 314 patients hospi- talized with COVID-19 and viral pneumonia at New York City-based NYU Langone Medical Center between March 31 and April 10. Patients included in the study were tested upon arrival to the emergency room using polymerase chain reaction tests, which also indicate viral load. Patients were classified into three groups based on the amount of viral load detected: low, intermediate or high. "High viral load was shown to be a predictor of poor out- comes above and beyond age, other medical problems and severity of illness on presentation, indicating that it can be used to risk-stratify, or triage, patients," Ioannis Zacharioudakis, MD, study author and infectious disease specialist at NYU Langone Health, said in a news release. Researchers also found that patients with comorbidities and transplant recipients were more likely to have higher viral loads at the time of hospital admission.n