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June 10, 2019

CT regulator nixes St. Francis-Manchester cardiac collab

HBJ Photo | Bill Morgan Manchester Memorial has won approval to launch emergency angioplasty services. However, the ECHN-owned hospital had hoped to also launch elective angioplasty, in partnership with St. Francis Hospital and Medical Center. In this photo taken last year, Manchester cardiologists Dr. Saquib Naseer (left) and Dr. Chandra Sachetti (right), pose with St. Francis cardiology chief Dr. Daniel Diver (center).
By Matt Pilon

A decision issued Monday by state health regulators could dash Manchester Memorial Hospital’s hopes of adding several major cardiac services.

The 238-bed Manchester Memorial Hospital wanted to open an on-site cardiac lab in partnership with St. Francis Hospital and Medical Center, to provide angioplasty and diagnostic catheterizations.

The Office of Health Strategy, ruled that the proposal wouldn’t improve care quality or accessibility, which are two key factors it assesses in its so-called “certificate of need” process.

“...there are already two hospitals within 10 miles of Manchester Hospital with emergency cardiac programs,” wrote OHS attorney and hearing officer Micheala Mitchell. “Establishing a third program in this service area only shifts volume, it doesn’t improve access. While a laudable intent, I was unable to find that the applicants demonstrated a clear public need for the proposal, or that its implementation would improve the quality of, or access to, cardiac care.”

The new services, including elective angioplasty, which is rare at community hospitals, had been projected to bring in more than $8 million a year in annual patient revenue, and over $2 million a year in profits, to ECHN, once fully up and running.

OHS also said the proposal doesn't meet guidelines set by the 2011 American College of Cardiology Foundation/American Heart Association/Society for Cardiovascular Angiography and Interventions for elective angioplasty.

Those guidelines state say "it is only appropriate to consider the initiation of [elective angioplasty] without on-site cardiac surgical backup if the program will clearly fill a void in the healthcare needs of the community. Institutional financial gain, prestige, market share, or other similar motives are inappropriate considerations..."

A spokesman from St. Francis Hospital and Medical Center, which is owned by Trinity Health of New England, declined to comment Monday afternoon after the decision was released.

In a statement, Nina Kruse, spokeswoman for ECHN, expressed disappointment in OHS' decision and said ECHN plans to appeal.

"We believe residents east of the river deserve to have the same access to these vital, life-saving services as other area residents," Kruse said. "By providing the proposed cardiac services at our local hospital, people living in eastern Connecticut who need cardiac interventions will be able to receive medical care more quickly and at a lower cost, allowing EMS providers to return to their town sooner and helping to minimize travel and wait times for all patients."

While community hospitals regularly provide emergency or “primary” angioplasty, as well as diagnostic caths, it’s much rarer to find one allowed to provide elective angioplasty.

That’s because community hospitals typically don’t offer open-heart surgery, which could be urgently needed in the event of an artery collapse or some other problem during the procedure.

Manchester’s proposal called for patients in those emergencies, which it said are increasingly rare, to be transported by ambulance to St. Francis.

Correction: A previous version of this story misattributed to OHS a professional guideline stating the conditions under which it would be appropriate for a hospital to launch an elective angioplasty program without on-site surgical backup. 

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