Care transition projects have been on the rise since CMS highlighted the them last year in its Care Transition Project, in which 14 communities nationwide worked to eliminate unnecessary hospital readmissions, according to an article in this month's Hospital & Health Networks Magazine. Where CMS focuses, insurers usually follow, and this seems to be becoming a trend with care transition and readmissions.
No longer are readmissions an epiphany, says Dr. P.J. Brennan, chief medical officer and senior vice president for the University of Pennsylvania Health System. "Some called these patients frequent fliers and in some ways it was thought that this [cycle of readmission] was the expected course of events. There was not much we thought we could do about it."
Cigna, for example, thinks there is a lot more to do. It now withholds payment for certain medical errors and is beginning to address readmission, the article reports. Dr. Douglas Hadley, the medical officer for Cigna's Healthcare Coverage Policy Unit, is focused on improving medical outcomes and patient safety, not necessarily costs. Aetna, too, has expanded on its own programs, and is identifying high-risk members for more intensive monitoring and case management regarding heart failure, where the company feels readmission is unnecessarily high.
With such a focus, there has been growth in evidence-based solutions that hospitals can use, such as the Joint Commission's brochure about how to plan for discharge. The group also has developed standards around discharge planning and suggested that accreditation teams could look rigorously at how healthcare organizations follow the standards. Other market organizations, state associations and hospitals themselves are conducting projects or publicly announcing readmission results in an effort to improve or tout their good records.
To learn more:
- read this Hospital & Health Network Magazine article