A pilot program introduced by the U.S. Centers for Medicare and Medicaid Services to boost quality of care for seniors by developing community approaches to health problems could play a key role in bringing down costs, in the Journal of the American Medical Association.
, or QIOs, are private groups in each state and U.S. territory that contract with the government for three years to improve health services for Medicare patients. They are comprised of health care providers and other medical professionals, social services workers and other community members.
In Tuesday鈥檚 report, researchers found a 5.7 percent average reduction in 30-day hospital readmissions across 14 economically and demographically diverse communities over a two-year period. The number of patients admitted to the hospital within 30 days of a prior admission is , since the cost and burden of readmission can be preventable.
One in five Medicare patients returns to the hospital within 30 days of being discharged. The problem is an expensive one: in 2004, these readmissions cost Medicare $17.4 billion dollars.
The interventions used by the 14 community groups varied, but they included efforts to improve medication management and transitional care for patients leaving the hospital. Author Dr. Jane Brock, a coordinator at the Colorado Foundation for Medical Care鈥檚 Medicare quality improvement program, said that providing social services that can monitor and track patient treatment was one key to the project鈥檚 success.
Author Dr. Joanne Lynn, a director at the , said the average community with 50,000 Medicare beneficiaries could have saved $4 million on readmissions alone if they used the various interventions that the QIOs practiced within their communities.
鈥淓ven those with low rates of readmissions had plenty [of hospitalizations] to be avoided,鈥滾ynn said.
The report also included the results from patient satisfaction surveys, emergency room visits and mortality rates to screen for negative changes from the interventions. They found that other health factors remained stable or improved with the reduction of readmissions.
Brock said the successful outcomes will help expand the idea of community based interventions.
鈥淢y hope is there is great recognition that this is the best purpose of the QIOs: We鈥檙e not competitors, we鈥檙e not regulatory, they really bring people together,鈥 she said.
