Two new programs to help curb hospital readmissions
With Medicare spending an estimated $12 billion on avoidable readmissions, according to the Medicare Payment Advisory Commission, two new programs are being introduced to help curb these costly, unneeded expenditures while improving patients’ quality of care. The Community-based Care Transitions Program (CCTP) and Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents are innovative programs that will potentially have a dramatic impact on safety, preventable harm, resources, and the bottom line.
The CCTP was created by the Affordable Care Act as a way to test potential programs that can improve care transitions from the hospital to the patient’s home, another health facility or other setting. There isn’t a set of rules for this program, rather it is an incentive to help get community-based organizations (CBOs) to develop their own community-centric methods that they best see fit to fix preventable readmissions and promote patient care. The focus on community-care measures hinge on the notion that only part of the problem can be fixed from within the hospital. A coordinated action plan that works in conjunction with a network of facilities that all promote patient self-care is optimal in keeping the patient healthy enough not to be readmitted.
CBOs approved for the CCTP will receive an all-inclusive rate per eligible discharge which is based on transition services costs. While many CBOs will apply to receive these all-inclusive rates from the $500 million in allotted funds, preference will be given for CBOs that provide services to underserved populations, small communities, and rural areas while offering interventions that span the continuum of care.
Earlier in March, the Centers for Medicare and Medicaid Services (CMS) added 23 sites the program bringing the total to 30 providers supporting over 126 hospitals and helping more than 223,000 Medicare beneficiaries throughout 19 states. By promoting community involvement to help improve transitions, avoidable readmissions and costs may be reduced while the patient experience is enhanced.
The second plan CMS has implemented for reducing readmissions has a more targeted approach. Like the CCTP the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents aims to curb avoidable readmissions for Medicare and Medicaid patients. However, CMS research specifically in this field has deemed 45% of hospital admissions from Medicare and Medicaid patients receiving skilled nursing facility services could have been avoided, resulting in $2.6 billion in Medicare savings.
Nursing facility residents are particularly at high risk for medical complications to arise as they are more likely to have over night hospital stays and be in a state of transition from the hospital. This initiative works by CMS partnering with independent, non-nursing facility organizations to develop and implement evidenced-based practices to decrease preventable readmissions. The $128 million initiative will strive for improving communication between providers and preventive services to aid low-income elderly patients and their families more personal care.
What suggestions would you make?
James Ellis, CEO, Health Care Realty Development Company, is a nationally recognized successful real estate investor and developer of medical office properties with a comprehensive knowledge of sophisticated real estate transactions, cost effective designs, and efficient property management.
Aaron Razavi is Associate Marketing Director at Health Care Realty Development.
Visit their blog at http://www.hcrealty.com/medicalrealestatedevelopment/
