February 22, 2013
In an interview earlier this month with Readmission News, a leading national newsletter on hospital readmissions, IMPAQ President Dr. Cary Sennett underscored the importance of innovations, such as the Centers for Medicare & Medicaid Services’ (CMS) Partnership for Patients (PfP) initiative and the Community-Based Care Transitions Program (CCTP),to reducing the risk and rate of readmission.
Dr. Sennett, an expert in quality and quality measurement, noted that IMPAQ is supporting CMS in evaluating and implementing these initiatives. He added that there was much that could be learned from efforts to understand the sources of variation in readmission rates across hospitals in the United States, and from programs like PfP and CCTP.
PfP is a bold strategy to reduce preventable readmissions by 20% by the end of 2013 through a national campaign to identify and diffuse best practices across the health system. A critical element of PfP is a self-assessment tool, developed by IMPAQ, which allows hospitals to determine to what extent they use evidenced-based best practices to reduce readmissions. Data from IMPAQ’s tool can help hospitals identify specific practices likely to reduce readmissions.
CCTP seeks to reduce readmissions by providing support to community-based organizations (CBO) that are working to improve transitions of Medicare beneficiaries from the inpatient hospital to other care settings. IMPAQ is part of a team that is evaluating the program to see if this intervention improves quality of care, reduces readmissions for high risk beneficiaries, and leads to measurable savings to the Medicare program. The study employs a new and innovative rapid-cycle evaluation strategy so that CMS can—quickly and efficiently—identify and disseminate best practices across the participating CBOs.
In his interview, Dr. Sennett commented on the measures that are currently being used to track hospital readmissions. He noted the considerable progress that those measures have made to address clinical risk, but added that there are patient-level factors—like socioeconomic status, educational attainment, and family structure—that are also important to understanding a patient’s risk for readmission.
“We know that patients vary with respect to behaviors, many of which (like follow up with a primary care physician) are critical to averting readmission, but patient-level factors that predict non-compliant behaviors are neither adequately understood nor adequately incorporated into risk adjustment models,” said Sennett.
Responding to a question on whether “Big Data” was the answer, Sennett noted that “better data”—such as those that are emerging from electronic medical records—may be more important than “big data” to opening a “more robust window on readiness for discharge;” thus on risk for readmission.
Dr. Sennett’s complete interview can be found here.