A state regulator that previously denied a proposed expansion of coronary angioplasty services at Manchester Memorial Hospital has changed its mind, at least partially.
Reversing part of its June proposed decision, the Office of Health Strategy on Friday said Manchester Memorial would be permitted to offer emergency angioplasty. However, OHS upheld its prior denial of the hospital’s request to launch an elective version of the procedure.
The originally proposed expansion could have meant $8.4 million in new revenue for Manchester Memorial and its parent, Eastern Connecticut Health Network.
Angioplasty, also known as percutaneous coronary intervention (PCI), is a non-surgical procedure that improves blood flow to the heart by opening a blocked artery using a balloon or stent.
Elective angioplasty is rare in community hospitals because they aren’t able to offer open heart surgery on-site if something goes wrong.
OHS on Friday upheld its prior proposed ruling that determined there wouldn’t be enough patient volume to justify the elective service in Manchester, and said it would take at least two years for the 238-bed hospital to accumulate that volume. Low volumes directly correlate to worse medical outcomes for the procedure, OHS said.
Partial win
Emergency angioplasty is done on patients who arrive at the hospital having a heart attack, making the immediate stakes higher.
For hospitals that are not authorized to do emergency angioplasty, medical guidelines say patients should be delivered to the nearest care provider that offers the service to ensure they receive the procedure within 120 minutes of medical contact.
OHS had previously ruled that both St. Francis Hospital and Medical Center and Hartford Hospital, each located about 10 miles away from Manchester Memorial, were close enough that an emergency angioplasty service at Manchester Memorial would be unwarranted. The hospital has been beating the recommended 120-minute “door-to-balloon” time in recent years, and was therefore not considered geographically isolated, OHS had ruled back in June.
However, in its final decision Friday, OHS said it considered additional data about highway auto accidents and found that Manchester Memorial was having difficulty meeting another key medical metric.
The average amount of time for assessing emergency angioplasty patients at Manchester and getting them out the door and en route to another hospital — the “door-in-door-out” time — had “greatly exceeded” the recommended 30 minutes in recent years, ranging from 43 minutes to nearly 64 minutes.
“Experts and policymakers all agree that faster door-to-balloon times are better for cardiac patients,” OHS Executive Director Vicki Veltri said in a statement. “In considering the new evidence Manchester Hospital submitted during oral argument, OHS was able approve the emergency angioplasty program under state guidelines — and that improves the accessibility of health care in Connecticut, benefits patients, and helps keep costs down.”
ECHN, owned by Prospect Medical Holdings, would have 15 days to request that OHS reconsider its decision, but it wasn’t immediately clear if it planned to make that request.
“We are evaluating the Office of Health Strategy’s decision and considering our options moving forward,” an ECHN spokesperson said Monday afternoon.
This story has been updated to add comment from ECHN.
