MANCHESTER — By denying expanded cardiac care at Manchester Memorial Hospital, regional government leaders and physicians said Monday the state is treating eastern Connecticut residents as less worthy of life-saving treatment than people on the other side of the river.
“I’m sick and tired of east-of-the-river being treated as second-class citizens,” Sen. Steve Cassano, D-Manchester, said.
The state Office of Healthcare Strategy announced last week that diagnostic and interventional coronary care already is available in nearby hospitals.
At a news conference Monday at Manchester Memorial, town and state leaders, physicians and hospital officials countered that people want and need a full range of heart care closer to home.
“This conversation is about lives that are going to be impacted,” Sen. Saud Anwar, D-South Windsor, said.
Anwar, who is also a physician, and other speakers stressed that in cardiac emergencies, time is critical in minimizing muscle damage and that I-84 West, the main route to hospitals in Hartford, is often jammed with traffic and sometimes shut down.
Also, people who live east of the river like to take care of their business, including their health care, in their own region, physicians and officials said.
“I’ve lived here all my life. It isn’t until you live here and you talk to people that you realize they don’t like going across that river,” Dennis McConville, chief strategy officer for ECHN, testified at the OHS hearing on the application in February.
Manchester Memorial and St. Francis Hospital and Medical Center, which have had a collaborative relationship, applied for a certificate of need to establish a diagnostic catheterization lab and angioplasty service without onsite surgical backup at the 238-bed Manchester hospital.
The diagnostic piece involves passing a catheter into the heart to identify blockages. Angioplasty involves inserting an expandable balloon into a blocked artery to improve blood flow. Both diagnosis and angioplasty are done by scheduled appointments and in emergencies.
“By providing the proposed cardiac services at our local hospital," ECHN spokeswoman Nina Kruse has said, “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 towns sooner and helping to minimize travel and wait times for all patients.”
OHS hearing officer and attorney Micheala Mitchell found, however, that "the program they seek to establish does not improve access to cardiac care for residents in the service area, nor does it advance the current quality of patient care.”
The state found, in part, that the applicants did not prove that towns in Manchester Memorial’s service area are “geographically isolated.” Under professional guidelines for diagnosis and intervention in cardiac emergencies, called “door to balloon time,” Manchester Memorial averaged 12 minutes less than the maximum 120 minutes, the OHS found.
Also, the agency found that the need for emergency angioplasty declined by 6 percent in the area from 2015-18 and there are two hospitals (Hartford Hospital and St. Francis) within 10 miles of Manchester Memorial with emergency cardiac programs.
ECHN plans to appeal the decision, Kruse said. The appeal for reconsideration has to be filed within 21 days of the state’s June 10 decision. Cassano vowed that the state’s “poor decision” would not stand. If necessary, he said, the state legislature will hold hearings to demand answers about the denial.
Since 2012, state regulators have denied five applications from hospitals to establish angioplasty services, including Manchester Memorial’s, and approved one, at Lawrence + Memorial Hospital in New London. Reasons for the denials included failure to prove geographic isolation.
Advocates for the services at Manchester Memorial, however, said the expanded care would bring a savings of $2,900 per patient on average compared with the cost for the same treatment at St. Francis. In three years, that would amount to $5.4 million in savings.
Eastern Connecticut Health Network, which also includes Rockville General Hospital, was sold in 2016 to for-profit Prospect Medical Holdings.
As for revenue, the applicants projected gains of $1,007,896, $1,888,265 and $3,158,677 in fiscal years 2020-22, respectively, according to testimony at the state hearing. But Dr. Saqib Nassar, president of ECHN’s medical staff and a Manchester cardiologist, said his motivation in supporting the expanded care is patients’ health and lives.
The state’s decision, Nassar said, is short-sighted and does not consider the demand for such services in the region. A chart displayed at the press conference that used state data showed people in several eastern Connecticut towns, including South Windsor, Vernon, Manchester and East Hartford, have higher rates of heart attacks and mortality from coronary disease than the state average.
“We feel this is related to timing of intervention, and we have learned the time it takes to get from eastern Connecticut to Hartford is growing,” Anwar said. “Between traffic accidents on Interstate 84 and events in the city, this leads to delays in care and worsens chances for survival.”
Jesse Leavenworth can be reached at firstname.lastname@example.org