New Legislation Would Work to Reduce Hospital Readmission Rates, Improve Patient Care & Save Billions of Dollars in Preventable Health Care Costs
Denver, CO - Michael Bennet, U.S. Senator for Colorado, introduced a new bill that would improve patient care and save billions of dollars each year in health care costs. The bill, the Medicare Transitions Act of 2009, would do this by ensuring Colorado and the nation's seniors receive effective follow-up care after they leave a hospital. Bennet also highlighted the Denver-based Care Transitions program, noting that Colorado is a leader in reducing readmission rates and improving patient care.
"Colorado's leading health care systems are at the forefront in delivering efficient health care and working to improve patient care. The Care Transitions program developed in Denver has produced dramatic reductions in readmission rates in Colorado. Colorado seniors have better care because of their work and the work of others around the state," Bennet said. "Across the country, too many seniors are being readmitted to a hospital within a month even though it could often be preventable. The legislation would bring Colorado's model to the nation and ensure better patient care for our seniors and their families, saving us billions each year."
For every five Medicare patients released from the hospital, one is re-admitted within a month, and more than three-quarters of these readmissions are potentially preventable. This cycle of re-hospitalization disrupts care for Colorado and the nation's seniors and costs Medicare more than $17 billion dollars every year. High re-hospitalization rates also put an increased burden on providers who often have trouble coordinating care with patients after they leave their health care setting.
Colorado has been a leader in developing transitional care programs to lower re-hospitalization rates. Dr. Eric Coleman, professor of medicine at the University of Colorado, developed the Care Transitions Intervention, a program that helps patients take ownership of their care and regain their independence after hospitalization. This program shrunk costly readmission rates at hospitals by as much as 35-50% in some communities. In addition, Rocky Mountain Health Plans, which serves the Western Slope, ensures timely follow-up care as patients move from one setting to another and leads the nations with a 3% readmissions rate, compared to the national average at 17.6%.
The Medicare Care Transitions Act of 2009 would create a nationwide network of community-based transitional care coaches who serve to improve patient quality and cost-effectiveness of care for Medicare beneficiaries and ease the burden on providers to reduce hospital readmission rates. At its core, some of the main functions these transition coaches provide include: helping patients self-manage their condition and medications over time, providing personal follow-up care, and serving as an access point when patients change care setting.
The bill calls for the creation of new collaborative community-based structures who are equipped to provide transitions care and work with the providers in the community. These community-based groups, as well as existing health systems that already provide some form of transitional coaching for patients, could apply for transitions coaching eligibility through the Department of Health and Human Services. Some of the criteria for being selected would include: professional expertise and capability to review medical records, demonstrated ability to work with providers in the community, and formal training in transitional care. These transitions coaches would serve Medicare beneficiaries who are considered a high-risk for hospital readmissions and receive reimbursement through achievement of quality outcomes and hospital readmission reduction targets.
In addition to discussing the bill, Bennet said there is an urgent need for health care reform across the country. "It will be impossible to get the federal deficit under control unless we get health care costs under control and invest in programs that we know will save money," Bennet said.
The bill, S. 1009, was introduced late Thursday and will be referred to the Senate Finance Committee.