MAY 22, 2012

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

Increasing the Number of Family Physicians Reduces Hospital Readmissions, Study Suggests
The Boston University School of Medicine and Boston Medical Center have released their findings concluding that adding a single family physician per 1,000 population potentially decreases annual readmission costs by $579 million. This reduction would generate 83% of the Affordable Care Act's target. (Science News, May 3, 2012)

Robocall Monitoring Reduces Hospital Readmission
Researchers at the American Telemedicine Association meeting reported that telemonitoring can reduce readmission rates. The study, conducted by the Geisinger Center for Health Research, found patients to be 44% less likely to be readmitted in the 30 days after discharge when monitored with Geisinger's interactive voice response (IVR) protocol. (Medscape, May 3, 2012)

A Randomized Controlled Trial of Telemonitoring in Older Adults with Multiple Health Issues to Prevent Hospitalizations and Emergency Department Visits
A related study conducted by researchers at the Mayo Clinic found opposite results. According to the authors of this study, "Among older patients, telemonitoring did not result in fewer hospitalizations or ED visits. Secondary outcomes demonstrated no significant differences between the telemonitoring group and the usual care group." (Archives of Internal Medicine, May 1, 2012)

Study Highlights How Health Information Exchange Can Cut Costs
The Journal of the American Medical Association's May issue includes a study from MidSouth eHealth Alliance (Memphis) which demonstrates providing ER physicians with HIE information reduced admission costs. (American Medical News, May 14, 2012)

Larger, Busier Hospitals Witness Higher Readmission Rates: Studies
The Journal of Healthcare Management Science recently published two studies from the University of Maryland on readmissions which suggest that poor planning and revenue-driven surgery lead to early discharges. The first study concludes that incentives to perform surgery lead to scheduling cases even when no beds are available. The second study suggested increasing post-surgery alternatives for patients and the use of post-surgery checklists. (Dorland Health, May 14, 2012)

Cara Health's Low-cost Phone Calls Could Reduce High Price of Readmissions
Cara Health, an informatics company of the Trinity College's Dublin Campus, is developing technology to linguistically analyze a patient's response to the question "How are you?" to predict the likelihood of a readmission to the hospital. (MedCity, May 9, 2012)

Expensive Hospital Readmissions Linked to Healthcare-Associated Infections
A study, led by Oregon State University's John Foruna, PhD and published in the June 2012 issue of Infection Control and Hospital Epidemiology, found a strong link between readmissions and hospital-associated infections. While the conclusion seems logical, the authors believe this study to be the first of its kind stating they found "...no studies have directly assessed the association between the two." (The Society for Healthcare Epidemiology in America, May 4, 2012)

The Care Transitions Program

This tool aims to facilitate a match between an individual's care needs during transitions of care. These strategies collectively hold promise for ensuring high quality transitional care.

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Medicare's Community-Based Care Transitions Program (CCTP)

Linda M. Magno
Director, Medicare Demonstrations, Center for Medicare and Medicaid Services, Washington, DC