If you see articles, publications, or additional materials that would be of interest to others in the Collaborative, please email those to Kim Streit at kims@fha.org.


President's Budget Includes Provisions on Readmissions
An outline of the President's 2010 budget, released last week, indicated the creation of a 10 year reserve fund of $630+ billion to finance health care reform efforts. While half of the money would come from taxes, the other half would be financed from program savings, including paying hospitals with certain readmission rates less for patients readmitted within 30 days (estimate savings of $8.43 billion over 10 years). Additionally, it proposes to bundle payments for hospital care and post acute care with savings of $17.84 billion over 10 years. We don't know a lot of details of how and whether it will only focus on potentially preventable readmissions, but this makes our project even more important.

CMS did note in the FY2009 proposed rule that "the application of incentives to reduce readmissions could promote the adoption of best practice interventions for averting avoidable readmissions. While CMS proposed looking at three things - direct adjustment to the DRG payments for avoidable readmissions or adjustments through a performance based payment methodology, either type of adjusted would likely require new statutory authority for CMS. So, Congress will need to consider legislation before this could be put in place.

Click Here for the AHA Special Bulletin, "White House 2010 Budget Outline Includes Hospital Provisions," February 26. 2009.

Cardiologists Set Heart-Failure Treatment Program
MARCH 29, 2009, Wall Street Journal

ORLANDO, Fla. -- The American College of Cardiology is launching a new initiative to reduce the number of patients who are readmitted to hospitals within 30 days of being discharged for congestive heart failure or a heart attack.

The effort is part of the professional society's broader plan to encourage its membership to rein in unnecessary tests and procedures and improve the quality of their care as President Barack Obama makes health-care overhaul a top priority of his administration.

In his presidential address at the ACC's annual scientific meeting Sunday, Douglas Weaver, a cardiologist at Henry Ford Hospital, Detroit, said cardiologists face "a defining moment" with an opportunity to lead the way to changing the health-care system instead of having it changed for them. "We can no longer maintain the status quo for the ways we currently provide and pay for health care," he said.

The college wants to reduce heart-failure readmissions 20% by December 2012. It plans to work with the nonprofit Institute for Healthcare Improvement, Cambridge, Mass., and other groups to help doctors and hospitals set up systems to ensure that patients discharged from the hospital after a heart-failure admission get appropriate medicines and followup doctor visits after they return home.

Heart failure is the Medicare program's most costly condition and is expected to be a focus of quality-improvement and cost-savings efforts by the Obama administration. The new program, called H2H, for Hospital to Home, will be modeled after the ACC's so-called Door-to-Balloon Alliance that has significantly improved care for heart-attack patients.

Guide Looks to Engage Patients and Families in Healthcare Quality

A team of healthcare organizations is working together to engage the patient and family in the healthcare experience. As part of the 2009 Accelerating Change and Transformation in Organizations and Networks research grants awarded by the Agency for Healthcare Quality and Research, a number of groups are creating the Guide to Patient and Family Engagement in Health Care Quality and Safety in the Hospital Setting. Click here to read the entire article.

New Guide Helps Patients Take Care of Themselves After Hospital Discharge

AHRQ has a new guide to help prepare patients to take care of themselves at home after they leave the hospital. The guide, Taking Care of Myself: A Guide for When I Leave the Hospital, helps patients by answering such questions as:

  • Whom do I contact if I have a problem?
  • What is my diagnosis?
  • What medicines have I been prescribed and when should I take them?
  • Which foods should I eat and what exercises should I do? Which should I avoid?
  • When are my next medical appointments, and what should I know about them?
  • What medicines can I safely take for headaches or other health problems?
Select to download a copy of the guide. Print copies of the bilingual guide (English/Spanish) are available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.

Studies/Other Presentations

CMS Inpatient Rule: Readmissions and Medicare Payment
Click this link to download - http://collab.fha.org/files/CMSreadmissions408.pdf

Reducing Hospital Readmissions, a report by Academy Health based on a meeting held on January 25, 2008. Click this link to download - http://www.academyhealth.org/publications/Reducing_Hospital_Readmissions.pdf

Rehospitalizations among Patients in the Medicare Fee-for-Service Program, Stephen F. Jencks, MD, MPH, Mark V. Williams, MD, and Eric A. Coleman, MD, MPH, published April 2, 2009, The New England Journal of Medicine.
Click this link to download - http://collab.fha.org/files/SJencksPublished2009.pdf

Rehospitalizations Webinar Presentations and Replay Available - The Commonwealth Fund webinar, "Reducing Rehospitalizations: A National Priority," held April 2, addressed the new Commonwealth Fund-supported New England Journal of Medicine article on the frequency and costs of readmissions. The panelists also outlined effective national, state, and facility-level strategies to redesign care delivery and payment methods to foster reduction in rehospitalization rates.

IHI Program on Reducing Re-Hospitalizations in a State or a Region
These presentations are from a one-day mini program offered by the Institute for Healthcare Improvement designed to increase understanding of key drivers of re-hospitalizations, identify high-leverage changes for reducing re-hospitalizations, and discuss a multi-stakeholder quality initiative. CLICK HERE to view presentations

Recorded Project RED Web Conference Available for Viewing -- the Agency for Healthcare Research and Quality (AHRQ) Web conference, Improving Patient Safety: Implementing Re-Engineered Hospital Discharges, was originally broadcast on March 31, 2009. To access the audio presentation and view slides from this recorded event, you my register for the free Web conference at: Go to Archive. You will have the option to select either "Real Player" or "Windows Media Player," and then click on "Launch Presentation."

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