Kentucky's seniors rank 48th in insurance firm's health rankings

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Kentucky seniors ranked in the bottom 10 states for 23 of the 35 measures ranked by the 2015 America's Health Ranking Seniors Report, placing Kentucky in 48th place for the second year in a row.

“The report is a call to action. We believe you can’t improve what you don’t measure,” Dr. Julie Daftari, market medical director for United Health Care of Kentucky told Alyssa Harvey of the Bowling Green Daily News. “It may start with seniors taking individual action. If we live long enough, we’ll be part of these statistics in the future."

Kentucky seniors ranked last in two areas, total health outcomes and preventable hospitalizations; next to last in premature deaths and education and in the bottom three states for smoking, seniors who are considered underweight, and poor mental health days.

The report notes that smoking is the leading cause of preventable death in the U.S. and "older smokers are at an increased risk of smoking-related illness as they tend to be heavy smokers with an average smoking duration of 40 years" and "are less likely than younger smokers to believe that smoking harms their health." Kentucky, with 11.8 percent of its seniors regularly smoking, ranked third highest in senior smoking, behind Nevada and Mississippi.

The report is intended to point out the health challenges facing today's seniors and offer a starting point to help states determine what needs to change. That being said, Kentucky ranks very low in an area that could help improve these outcomes: community support, where it ranks 45th.

The report did say that Kentucky seniors do have some strengths. They have a low prevalence of chronic drinking, low percentage of adults needing pain management, high flu vaccination coverage and a low percentage of low-care nursing home residents.

More Kentucky seniors also reported very good or excellent health since last year's report, up to 33.7 percent from 31.2 percent.

The report noted that a decrease in physical inactivity is a nationwide problem for seniors, with 33.1 percent of seniors nationwide reporting they did not get enough physical activity. This percentage was even higher in Kentucky at 40.2 percent, which is higher than the previous two years (34.5 percent in 2014 and 17 percent in 2013).

The report notes that today, one in seven Americans are aged 65 and older, and in the next two decades the rest of the 77 million baby boomers will move into this demographic. The report also projected the increase in Kentucky's senior population between 2015 to 2030 will be 41.8 percent.

“The fact that we were able to identify key strengths and challenges gives Kentucky an opportunity to address those specific issues,” Daftari told Harvey. “If these challenges aren’t addressed, there may be a significant strain on health care in the future.”

The rankings were based on 35 measures of senior health including behavior determinants like smoking and dental visits; micro and macro community and environmental determinants like poverty and social support; policy issues like percentage of seniors on SNAP; and measures of clinical care like the percentage of seniors who receive home health.; and outcomes like the percentage of seniors who have fallen. It also included measures like education and cognition.

Most Kentucky hospitals did average or better in new patient satisfaction ratings; seven got top rating and six got bottom rating

Most of the Kentucky hospitals that were rated on a newly released five-star scale for patient satisfaction got three and four stars. Seven of them got a five-star rating and six got a two-star rating, the lowest rating given to any of the Kentucky hospitals that were evaluated.

The star ratings can be found on Medicare's Hospital Compare website and are based on a patient satisfaction survey given to randomly selected patients, not just those on Medicare, at nearly 3,500 Medicare-certified acute care hospitals across the country. The ratings are based on patient admissions between July 2013 and June 2014. Hospitals were not included if they did not have enough surveys completed during that period.

The survey, also known as Hospital Consumer Assessment of Healthcare Providers and Systems Survey, includes questions about patient satisfaction related to how their doctors, nurses and hospital staff communicated with them, how well their pain was addressed during their hospital stay, how well they were prepared to go home, cleanliness of the hospital and if they would recommend the hospital to others.

Kaiser Health News analyzed the data from the Centers for Medicare & Medicaid Services and found that 76 Kentucky hospitals were included in the patient satisfaction star ratings and 17 Kentucky hospitals were not. Kaiser found that the average for all of the rated hospitals in Kentucky was 3.4 stars, one-third, or 25, got four stars; half, or 38, got three.

HealthWatch USA, a non-profit organization that promotes health care transparency and patient advocacy based in Somerset, further analyzed the data and named the hospitals in each state by its star rating.

The seven with five-star ratings are: Clinton County Hospital, Marshall County Hospital, Westlake Regional Hospital, Saint Joseph Martin, Rockcastle County Hospital, Pikeville Medical Center and Russell County Hospital.

The six with two-star ratings are: Georgetown Community Hospital, Harlan ARH Hospital, Hazard ARH Regional Medical Center, Spring View Hospital in Lebanon, University of Louisville Hospital and Lake Cumberland Regional Hospital in Somerset.

The Centers for Medicare and Medicaid Services reminds consumers that these patient satisfaction star ratings are just one tool to help decide which hospital to use, and encourages them to use multiple factors to make this decision, including clinical outcomes, their health-care providers opinion and other publicly reported data.

Federal agency offers a consumer-friendly website that ranks patients' experiences in your local hospitals

Consumers now have access to a website that ranks 3,500 hospitals around the country on patients' experiences to help them choose a hospital and better understand the quality of care participating hospitals offer, according to a Centers for Medicare and Medicaid Services press release.

The 12 star ratings on Hospital Compare are based on 11 of the publicly reported measures from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, and a summary rating for the survey. The survey asks patients questions about nine topics:communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. This survey information is self-reported by patients and will be updated quarterly.

“The patient experience star ratings will make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in health care quality,” Dr. Patrick Conway, acting principal deputy administrator for the CMS, said in the release.

Consumers already have access to Medicare star systems to rate nursing homes, dialysis centers, private Medicare Advantage insurance plans and certain situations for physicians and group practices, but are they using it?

Not much, according to a recent Kaiser Family Foundation poll. It found that only 31 percent of those polled had seen any information comparing doctors, hospitals, and health insurance plans in the past 12 months. When asked specifically if they had seen information comparing prices or quality across plans and providers, fewer than 1 in 5 people said they had seen such information, and fewer than one in 10 reported using such information.

CMS said the website helps meet goals of the Patient Protection and Affordable Care Act, which calls for transparent, easily understood and widely available public reporting. The agency also reminds consumers that the site is just one tool to help them make a decision abut which hospital to use, and encourages them to talk to their health-care providers about hospital quality, and to use "multiple factors" when deciding about a hospital, such as clinical outcomes and other publicly reported data that is on the website.

To see the rankings:

• Go to the Hospital Compare website
• Type in your ZIP code, or the name of a particular hospital
• Click on "Search"
• Choose three hospitals, by clicking on the "Add to Compare" button
• Click on "Compare Now," located at the top of the screen
• Click on "Survey of Patients' Experiences"
• Scroll down and view star ranking and additional information results

This is a screen shot of the final screen, with a bar of options to click on.

Paducah Baptist and Ashland hospitals 'above average' in Consumer Reports' ratings of hospitals for heart surgery

Baptist Health Paducah
(formerly Western Baptist Hospital)

By Melissa Landon
Kentucky Health News

Consumer Reports has reported ratings of hospitals for heart-valve and coronary artery bypass surgery based on hospitals' reports to the Society of Thoracic Surgeons. More than 400 hospitals in 45 states have been rated, based on "medical records showing whether patients survived the procedure and how they fared on other important measures, including complications," the magazine says.

Although more than 1,000 hospitals send data to STS, only 400 allowed it to be shared with Consumer Reports. Of those did, "20 percent (83) were above average, 75 percent (310) were average and 4 percent (18) were below average," the magazine reports. Robbin Cohen, a cardiothoracic surgery professor at the University of Southern California, said the STS has very high standards, so hospitals with average scores do a very good job.

King's Daughters Hospital, Ashland

King's Daughters Hospital in Ashland and Baptist Health Paducah (formerly Western Baptist Hospital) were the only Kentucky hospitals ranked above average for either type of procedure (and in their cases, only for bypasses). King's Daughters recently agreed to a huge settlement with the federal government for doing unnecessary heart procedures.

Four Kentucky hospitals were listed as below average for both procedures: Lourdes Hospital in Paducah and Jewish Hospital, Norton Hospital and Norton Audubon Hospital. Two were listed as below average for bypass and were not listed for valve: Baptist Health Lexington and Baptist Health Madisonville.

Several hospitals near Kentucky were on the list. Mercy Health-Anderson Hospital in Cincinnati was rated below average for bypass and was not listed for valve surgery. In Missouri, Poplar Bluff Regional Medical Center and Cape Girardeau's Saint Francis Medical Center were rated below average on both.

In Tennessee, Nashville's Tristar Centennial Medical Center and Saint Thomas Midtown Hospital were below average on both, but Saint Thomas West Hospital, was above average for bypass and below average on valves. In Knoxville, the Univerity of Tennessee Medical Center and its Fort Sanders Regional Medical Center were below average on both, and Parkwest Medical Center was above average on bypass and below average on valve. Wellmont Holston Valley Medical Center in Kingsport was below average on both, and Johnson City Medical Center was above average on bypass and below average on valves.

The top hospitals in the nation were Baystate Medical Center in Springfield, Mass., Borgess Medical Center in Kalamazoo, Mich., and Cleveland Clinic, which attracts some Kentuckians. To see the full list of ratings, click here.