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Medicare quality improvement project helps physicians see the benefit of evidenced-based practices
e-Reports, April 18, 2011
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The Centers for Medicare & Medicaid Services (CMS) selected Health Care Excel, Indiana’s Medicare Quality Improvement Organization (QIO) as one of only 14 QIOs in the nation to participate in its Care Transitions Project.

The goal of the effort is to improve health care processes so that patients, their physicians and their entire health care team have what they need to keep patients from returning to the hospital for preventable readmissions.

“Our interventions include use of evidence-based practices like coaches and patient navigators post discharge, as well as early priority scheduling for high-risk patients to ensure they are seen seven to 14 days after discharge from the hospital,” said Clinical Specialist Nancy Meadows, R.N., B.S., with Health Care Excel (HCE).

In our state, the QIO has concentrated its efforts to reduce 30-day re-hospitalization rates in the Evansville area, including Vincennes. “The Care Transitions Project has provided an opportunity to significantly impact the health care experience for southwestern Indiana residents and to improve the quality of care for its Medicare beneficiaries,” noted Meadows.

By promoting seamless transitions from the hospital to home, skilled nursing or home health care, this community-wide approach has sought not only to reduce hospital readmissions, but to yield sustainable and replicable strategies that achieve high-value health care for Hoosier beneficiaries.

“Large health care systems have expanded the pilot projects and are sustaining models of care and sharing data nationally,” said Meadows.

According to the QIO Care Transitions Theme Support Center, approximately $11.7 million was saved during 2009 by the 14 QIOs participating around the country when compared to 2007, the baseline year. An estimated 35,340 patient care transitions were positively affected by interventions.

Results are attracting attention. “Physicians see the benefit,” Meadows said. “We’re being asked to talk to physician groups, medical societies and at grand rounds at hospitals. Doctors are becoming more aware of the gaps in the continuum of care, and they’re looking for ways to improve care across all settings.”

For further information, contact the Care Transitions team at (812) 234-1499, extension 221, or email Dr. Roland Grieb.

To learn more about HCE, Indiana’s Medicare QIO, see the March 21 ISMA Reports.

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