Readmissions Targeted by IL Blues, Hospitals

"This collaboration leverages IHA's experience and relationships with hospitals, the expertise of the academic community and resources from BCBSIL," said Scott Sarran, MD, BCBSIL vice president/CMO. "We expect this collaboration to have a positive impact on improving the way hospitals, physicians, and other healthcare providers transition patients to outpatient care in the community."

The Commonwealth Fund State Scorecard 2009 ranked Illinois 44th in the nation for its high rate of Medicare 30-day readmissions as a percentage of admissions. The state had a readmissions rate of 20.3%, an increase from 19.6% in 2007. Nationally, the median is 17.5% and the average for the top five states is 13.8%.

In 2009, there were more than 50,000 readmissions to Illinois hospitals, with each patient spending, on average, five additional days in the hospital. Sarran said improving the Illinois readmission rate to the current national average has the potential to save or avoid costs of approximately $150 million dollars in the first year.

BCBSIL expects to invest up to $1 million a year over the next four years to reduce preventable hospital readmissions. "Our commitment to this program is part of our ongoing efforts to work with health care providers to improve the quality of care and slow increasing health care costs," Sarran said.

More than 200 Illinois hospitals have pledged to reduce readmissions by the end of 2013 with the goal of raising the state's performance from the bottom quartile to an upper quartile, IHA President Maryjane A. Wurth said.

 "Over time, these savings will go back to the taxpayers and businesses in Illinois, as the state (Medicaid), the federal government (Medicare), employers, and individual policy holders in the form of lower healthcare costs," Wurth said. "More importantly will be the improved health and safety of patients, and the satisfaction hospital and physician partners receive from being able to deliver improved care."

The initiative—Preventing Readmissions through Effective Partnerships – will team with the Division of Hospital Medicine at Northwestern Memorial Hospital, and Northwestern University Feinberg School of Medicine and the Society of Hospital Medicine, to reduce readmissions by 2014, focusing on:

• ·        Redesigning hospital discharge processes;
• ·        Improving transitions of care;
• ·        Developing and improving palliative care programs;
• ·        Reducing readmissions from infections; and
• ·        Measuring reductions in readmissions using standardized metrics

PREP will stress patient education—assessing a patient's needs before discharge, and making sure they have the information they need for a smooth transition. This patient/provider partnership includes standardized discharge planning that highlight medications, follow up, pending tests, self-management instructions, and goal setting, IHA and BCBSI said.

See Also:
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