APRIL 5, 2012

Welcome to the Medicare Readmissions Update eNewsletter
This issue sponsored by the Medicare Medicaid Payment Summit

Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents
The CMS Innovation Center and the CMS Medicare-Medicaid Coordination Office hosted an April 3 webinar on this new initiative, which is designed to improve care for people living in nursing facilities who are enrolled in Medicare and Medicaid. (CMMI, April 2012)

New Readmissions Initiative to Rely Heavily on Technology
This piece on the new $128 million CMS nursing home initiative quotes Melanie Bella, CMS Deputy Administrator and Director of the CMS Medicare-Medicaid Coordination Office, as saying that CMS believes as much as 45% of hospital readmissions from nursing homes are avoidable. (McKnights.com, April 2)

When Is 7.69 a Spectacular Number?
The answer? When it's your hospital readmission rate for high risk patients That's the rate for January 2012 for Southeast Texas Medical Associates (SETMA), in Beaumont, Texas. (Heathcare-Informatics.com, April 3)

Longer HF Hospitalizations Cut Risk of Readmission in Analysis
An analysis of 7000 patients in the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF), from countries all over the world, found a significant drop in the odds of a 30-day readmission for heart failure patients for each extra day spent in the hospital. (TheHeart.org, April 3)

Simple Heart Failure Checklist Reduces Readmission Rates, Improves Care, Could Save Billions
Clinicians at St. Joseph Mercy Oakland Hospital in Pontiac, MI who used a one-page, 27-question checklist at discharge for heart failure patients were able to cut the percentage of patients who were readmitted to the hospital within one month of a cardiac event from 20 percent to just 2 percent. The readmission rate continued to be lower six months after discharge. (CardioSource.org, March 24)

Hospitals Tackle Patient Readmission Problem
The Glendale Healthier Community Coalition has formed a task force composed of local hospitals and health care and social service agencies to address the problem of a 20% hospital readmission rate. About 40,000 patients are discharged from the area's hospitals each year, including a substantial foreign-born population that may have cultural, language, or access barriers. (Glendale News-Press,com, March 24)

County Joins with Marin Hospitals to Reduce Medicare Patients' Return Visits
And up in the Bay Area Marin County has joined forces with Marin General Hospital and Novato Community Hospital to reduce hospital readmissions. The new initiative is called Advanced Care Transitions and is one of 30 such community initiatives nationwide recently awarded a grant from CMS to test new collaborative approaches to reducing readmissions. (MarinIJ.com, March 25)

UnitedHealthcare, Dovetail Health Launch Innovative Program to Reduce Unnecessary Hospital Readmissions in New Jersey
UnitedHealthcare and Dovetail Health have launched a pilot in New Jersey designed to help United's Medicare Advantage members avoid unnecessary hospitalizations and reduce readmissions after a stay at a hospital or skilled nursing facility. A specially trained pharmacist care manager from Dovetail Health will visit patients in their home, review their medications, discuss how these medications should be taken, answer questions, and identify ways to better coordinate their care. (Yahoo!Finance, March 21)

Geisinger Health Plan and AMC Health Find Success with Remote Patient Monitoring
Geisinger Health Plan (GHP), using interactive voice response (IVR) and other telemonitoring technology and solutions provided by AMC Health, demonstrated a 44% reduction in the odds of 30-day readmissions compared to a control group. (AMC Health, March 22)

Engaging Members in Telephonic Case Management

Source: Healthcare Intelligence Network, Telephonic Case Management: Protocols for Behavioral Healthcare Patients, March 7, 2012

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The Era of Care Transitions at CMS

Paul McGann, MD
Deputy Chief Medical Officer, Office of Clinical Standards and Quality, Centers for Medicare and Medicaid Services, Baltimore, MD