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Guide to Reducing Medicare Readmissions, Vol. II

Healthcare Intelligence Network, June 2011, Pages: 120


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Reimbursement models shaped by the Patient Protection and Affordable Care Act reward the reduction of fragmented care and unwarranted utilization. Much avoidable use of healthcare services is attributed to Medicare beneficiaries.

The Guide to Reducing Medicare Readmissions, Vol. II examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. This guide looks at four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population — and that support an accountable care vision.

The profiled programs are designed to shore up the critical patient handoffs of hospital-to-home and hospital-to-skilled nursing facility (SNF); identify functional decline in the elderly (a harbinger of high utilization); and enlist the help of community pharmacists in improving medication adherence. They are the result of innovation by HealthCare Partners Medical Group, Fallon Community Health Plan, Summa Health System, Highmark, University of Pittsburgh School of Pharmacy and Rite Aid pharmacies.

This guide also provides a complete set of 2011 benchmarks in reducing readmissions from nearly 100 healthcare organizations.

Applying the best practices contained in the Guide to Reducing Medicare Readmissions, Vol. II will help organizations to improve the health of their populations, enhance the patient experience of care and rein in costs associated with avoidable utilization.



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