Home Health & Hospice Week

Individual Quality Improvement Organizations have already been telling the popular pressabout their new Care Transitions projects to prevent unnecessary hospital readmissions, but now the Centers for Medicare & Medicaid Services has made the launch of the program official.

CMS has announced 14 communities or areas that will implement the program through QIOs: Providence, R.I.; Upper Capitol Region, N.Y.;Western Pennsylvania; Southwestern New Jersey;Metro Atlanta East, Ga.; Miami; Tuscaloosa, Ala.;Evansville, Ind.; Greater Lansing Area, Mich.;Omaha, Neb.; Baton Rouge, La.; North West Denver, Colo.; Harlingen, Texas; and Whatcom County, Wash.

The QIOs for Texas and Louisiana already have started publicizing their campaigns (see Eli's HCW, Vol. XVII, No. 40 and Vol. XVIII, No. 12).IPRO, the QIO for New York, issued a press release about the same time CMS did.

Each community will tailor its hospital readmission prevention project to its own specifics,CMS notes in a release. "The Care Transitions Project is a new approach for CMS," said CMS's chief medical officer Dr. Barry M. Straube."Rather than focusing on one global problem and trying to apply a one-size-fits-all solution across the country, Care Transitions experts will look in their own backyards to learn why hospital re-admissions occur locally and how patients transition between health care settings. Based on this community-level knowledge, Care Transitions teams will design customized solutions that address the underlying local drivers of re-admissions."

Home care participation: So far, all the QIOs announcing their programs have included home care providers in them. IPRO also includes hospice. Under the project, "QIOs will promote seamless transitions from the hospital to home, skilled nursing care, or home health care," says CMS Care Transitions contractor Colorado Foundation for Medical Care on the project Web site.

"Home health agencies in the 14 communities are urged to participate in projects," says the National Association for Home Care & Hospice."Also, home health agencies should stay alert for a QIO special home health campaign which will involve work that will share the goal to reduce unnecessary hospitalizations through health care community wide initiatives."

The project is part of the QIOs' 9th Statement of Work.

High cost: The program can't seem to come soon enough. A study in the April 2 New England Journal of Medicine estimates that unplanned rehospitalizations cost Medicare about $17.4 billion in 2004. Almost one-fifth of Medicare beneficiaries who had been discharged from a hospital were rehospitalized within 30 days, and 34 percent were rehospitalized within 90 days, note the researchers. Half of those rehospitalized didn't visit a doctor first.