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Medicare QIO Study Reduces Hospital Readmissions: JAMA article details success

Published Friday, January 25, 2013

The January 23/30 issue of the Journal of the American Medical Association (JAMA) highlighted a community-based pilot study that showed 30-day hospital readmissions reduced by nearly 6 percent. The study was conducted over two years by Medicare Quality Improvement Organizations (QIOs) in 14 communities.

One in five Medicare patients return to the hospital within 30 days of discharge. The 14 participating communities in the QIO pilot study reduced readmissions by nearly 6 percent compared with similar communities over two years. As a result, thousands of Medicare beneficiaries with complex conditions and follow-up care did not need to rebound to the hospital for the same condition. The authors estimate that in an average community with 50,000 Medicare patients, spending $1 million on relatively simple steps to curb hospitalizations would save $4 million per year on hospital bills alone. Researchers reported consistent improvements in both poor and affluent communities.

The Centers for Medicare and Medicaid Services expanded this work in August 2011 to all Medicare QIOs across the country, including Minnesota's Medicare QIO, Stratis Health. QIOs serve as local change agents for CMS to spread quality improvement best practices to improve care for Medicare beneficiaries.

"Medicare has called the health care community to action to tackle an expensive problem directly tied to patients' quality of care and quality of life," said Jennifer Lundblad, Stratis Health president and CEO. "This work requires people to problem solve as a community. Hospitals, nursing homes, clinics, other health care organizations, as well as patients and families, and social service providers, all can play a part in reducing hospital readmissions. We are pleased to be building on the work of our colleagues in these 14 communities to improve care transitions and reduce unnecessary hospital readmissions in Minnesota."

In Minnesota, work to reduce avoidable hospital readmissions is being coordinated through the RARE Campaign, www.rarereadmissions.org, being led by Stratis Health; the Minnesota Hospital Association; and the Institute for Clinical Systems Improvement. The 83 Minnesota hospitals participating in the RARE Campaign collectively have 12 percent fewer avoidable readmissions than expected through the second quarter of 2012, representing approximately 3,128 prevented readmissions, from the 2009 baseline, as measured by MHA's Potentially Preventable Readmissions (PPR) data. This change means that patients were able to spend 3,000 more nights in their own beds rather than in the hospital.*

Many hospitals have been working on readmissions to improve patient care. A 2010 national health reform law increased the urgency for change with penalties for hospitals with high rates of repeat Medicare patients who have acute myocardial infarction, heart failure, or pneumonia. The law also creates incentives for hospitals to prevent patient readmissions by improving discharge processes and transitions from the hospital to the community.

* 4,000 readmissions X average length of hospital stay (4 days) = 16,000 nights of sleep in their own beds.