In recent months, the debate over how best to reduce avoidable hospital readmissions has become a hot topic in the national media. While many are just now joining the fray, the John A. Hartford Foundation has been working on this issue for years.
Hartford grantees have developed evidence-based models that are now in the forefront of the national debate, including Eric Coleman’s Care Transitions Intervention, Mary Naylor’s Transitional Care Model, and the Society of Hospital Medicine’s Project BOOST.
It also has been a topic we have written about extensively on our Health AGEnda blog as we seek to help shape the public debate about an issue that is at the very core of real and sustainable health care reform and of critical importance to older adults.
Here is a crash course in what we’ve written so far to help prepare you for the battles to come. Don’t worry: There’s no pop quiz at the end:
A great place to start is with Amy Berman’s January 2010 post about the Hartford Foundation’s collaboration with the Commonwealth Fund to support creation of the “Health Care Leader Action Guide to Reduce Avoidable Readmissions” by the Health Research and Education Trust (HRET) of the American Hospital Association.
Just three months later, Chris Langston reported from the joint meeting of the American Society on Aging/National Council on Aging in Chicago, where Health and Human Services Secretary Kathleen Sebelius spoke about the importance of reducing hospital readmissions, among other topics.
As details of health care reform implementation became public, Langston voiced concerns that those who know the most about caring for frail older adults don’t have a seat at the table and highlighted the need to improve communication between team members in the health care system and patients and their families.
Other posts have dealt with:
• the Hartford Foundation’s role in identifying an inefficiency in the system where costs could be reduced and care improved
• the Centers for Medicare and Medicaid Services’ decision to invest $500 million to create independent, community-based teams to facilitate safe transitions from hospitals to home for vulnerable Medicare beneficiaries
• an innovative program devised by Holy Cross Hospital in Silver Spring, Md., in which a geriatric social worker plays a key role in helping older adults get the care they need after hospital discharge. As Nora OBrien-Suric points out, in addition to having a fulltime geriatric social worker on staff, the hospital requires geriatric training for nurses and doctors.
• the role that health information technology can play in reducing hospital readmissions
• the potential impact of new CMS codes in the Physician Fee Schedule on hospital readmissions
In recent months, as the debate really started to heat up, Marcus Escobedo explained why the controversy is actually a good thing, while Langston took on a Wall Street Journal op-ed assailing the financial penalties that are part of Medicare’s readmissions reduction program.
And earlier this summer, Langston reported from the National Health Policy Forum in Washington, D.C., detailing the failings of our current health care system and making the case for why we must take on the complex and scary task of fixing it.
The debate is far from over, and it’s important that those with expertise in geriatrics be fully engaged. We would love to hear what you think, so please join the discussion here by sharing your comments.