Medicare Selects 14 Communities for Program to
Reduce Unnecessary Hospital Readmissions
Seeks seamless transitions from the hospital to home,
skilled nursing care, or home health care
April 14, 2009 Data collected by the Centers of
Medicare & Medicaid Services indicates that many hospital readmissions
of Medicare patients are preventable and, yesterday, the agency
announced a program in 14 communities aimed at eliminating these
unnecessary hospital readmissions.
The goal of this Care Transitions Project is to
improve health care processes so that patients, their caregivers, and
their entire team of providers have what they need to keep patients from
returning to the hospital for ongoing care needs, according to CMS.
By promoting seamless transitions from the hospital
to home, skilled nursing care, or home health care, this community-wide
approach seeks, not only to reduce hospital readmissions but to yield
sustainable and replicable strategies that achieve high-value health
care for Medicare beneficiaries
Our data show that nearly one in five patients who
leave the hospital today will be re-admitted within the next month, and
that more than three-quarters of these re-admissions are potentially
preventable, said CMS Acting Administrator Charlene Frizzera.
This situation can be changed by approaching
health care quality from a community-wide perspective, and focusing on
how all of the members of an areas health care team can better work
together in the best interests of their shared patient population.
CMS will monitor the success of this project by
watching the rates at which patients in these communities return to the
hospital. Re-admission rates for hospitals have been tracked by CMS for
some time, and will be available to consumers later this year through
the Hospital Compare Web site at
http://www.hospitalcompare.hhs.gov.
The Care Transitions Project is a new approach
for CMS, added Barry M. Straube, M.D., chief medical officer for CMS
and its Office of Clinical Standards & Quality director.
Rather than focusing on one global problem and
trying to apply a one-size-fits-all solution across the country, Care
Transitions experts will look in their own backyards to learn why
hospital re-admissions occur locally and how patients transition between
health care settings. Based on this community-level knowledge, Care
Transitions teams will design customized solutions that address the
underlying local drivers of re-admissions.
Communities in the following regions have been
selected to participate in the project:
Providence, R.I.;
Upper Capitol Region, N.Y.;
Western Pennsylvania;
Southwestern New Jersey;
Metro Atlanta East, Ga.;
Miami, Fl;
Tuscaloosa, Ala.;
Evansville, Ind.;
Greater Lansing Area, Mich.;
Omaha, Neb.;
Baton Rouge, La.;
North West Denver, Colo.;
Harlingen, Texas; and
Whatcom County, Wash.
The work of the Care Transitions Project will
respond to the unique needs of each of the 14 communities, says CMS.
Each of the CTP communities is led by a state
Quality Improvement Organization (QIO). QIOs work throughout the
country as part of CMSs quality program to help health care providers,
consumers and stakeholder groups to refine care delivery systems to make
sure all Medicare beneficiaries get the high-quality, high-value health
care they deserve.
Each QIO in the project is required to work with
partners to implement the following:
a) Hospital and community system-wide
interventions;
b) Interventions that target specific diseases or
conditions; and
c) Interventions that target specific reasons for
admission.
The following QIOs serve as Care Transitions
leaders throughout the country:
Quality Partners of Rhode Island;
IPRO Inc. (in New York);
Quality Insights of Pennsylvania;
Healthcare Quality Strategies Inc. (in New Jersey);
Georgia Medical Care Foundation Inc.;
FMQAI (in Florida); AQAF (in Alabama);
Health Care Excel (in Indiana);
MPRO (in Michigan);
CIMRO of Nebraska;
Louisiana Health Care Review;
Colorado Foundation for Medical Care;
TMF Health Quality Institute (in Texas); and
Qualis Health (in Washington).
The Care Transitions Project will continue in all
14 communities through summer 2011. For more information about the Care
Transitions Project, visit
http://www.cfmc.org/caretransitions/. To learn more about the work
that QIOs are doing across the country, visit
http://www.cms.hhs.gov/qualityimprovementorgs.
