IPRO Initiative Reduces Rehospitalizations

Albany-area hospitals, nursing homes and home health agencies that worked collaboratively with IPRO on improving transitions of care were able to show statistically significant reductions in 30-day rehospitalizations and all hospitalizations for Medicare beneficiaries.

Study results appeared in the January 23, 2013 edition of the Journal of the American Medical Association (JAMA). The communities working with Medicare-funded Quality Improvement Organizations (QIOs) like IPRO showed nearly twice the reduction in hospitalizations and rehospitalizations as those not working with QIOs. “The QIOs’ work in this project shows a reduction in hospitalization and rehospitalization rates, which are vitally important for keeping Medicare beneficiaries as healthy as possible for as long as possible,” said Patrick Conway, MD, MSc, CMS Chief Medical Officer and Director of the Agency’s Center for Clinical Standards & Quality. “Thanks to QIOs, these communities created networks of clinicians, facilities, families, social services agencies, and others that share a common language in coordinating care for patients—the community’s sickest and most vulnerable people. These communities effectively prevented hospitalizations, resulting in people being more likely to stay home and healthy.” The study looked at results from 2009 to 2010, focusing on 14 communities across the U.S. Close to 50 healthcare providers in New York’s Rensselaer, Saratoga, Schenectady, Warren and Washington counties took part.

Care transitions take place when patients move from one setting to another, such as from hospital to home or nursing home. According to study authors, New York’s Upper Capital Region achieved 5.1% relative improvement for hospital readmissions for more than 68,000 Medicare beneficiaries, and reduced hospitalizations by 5.46%. Communities of comparable size, demographics and hospital utilization—but where there were no concerted efforts to improve care transitions—averaged considerably more modest reductions, just a 2.05% drop in rehospitalizations and a 3.17% decline in hospitalizations. “We are gratified that this well-designed study has confirmed what we already knew: that by working with IPRO in a concerted, collaborative effort, New York’s healthcare community can significantly improve care for the state’s residents,” said Clare B. Bradley MD, MPH, Senior Vice President and Chief Medical Officer. “We look forward to continued progress as we move forward with new care transitions initiatives.” Nationally, the 14 communities in the JAMA study averaged a 5.7% reduction in rehospitalizations. Medicare beneficiaries in these communities also experienced a 5.74% reduction in hospitalizations over the two-year period. The U.S. Department of Health & Human Services has established a goal of 20% reduction in avoidable rehospitalizations. Reliable estimates are that 76% of rehospitalizations may be preventable. Due to the success of the QIOs’ 9th SOW projects, CMS is now funding all QIOs across the U.S. to continue community-based readmission reduction efforts through July 2014.

IPRO has purchased a limited number of article reprints it is making available to stakeholders across New York. To request a reprint, contact Joan Ragone in IPRO’s Communications Department at 516-326-7767, ext. 262.