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Improving Transitions from Hospital to Community Care: Models that Work David G. Schulke Vice President, Research Heal

Acknowledgements. This presentation is supported by the Agency for Healthcare Research and Quality (AHRQ) through a Knowledge Transfer contract with the Health Research and Educational Trust (HRET).HRET is a charitable and educational organization affiliated with the American Hospital Association..

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Improving Transitions from Hospital to Community Care: Models that Work David G. Schulke Vice President, Research Heal

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    1. Improving Transitions from Hospital to Community Care: Models that Work David G. Schulke Vice President, Research Health Research and Educational Trust Missouri Hospital Association Seminar March 29, 2011

    2. Acknowledgements This presentation is supported by the Agency for Healthcare Research and Quality (AHRQ) through a Knowledge Transfer contract with the Health Research and Educational Trust (HRET). HRET is a charitable and educational organization affiliated with the American Hospital Association.

    3. The Health Research and Educational Trust (HRET) A 501(c)(3) affiliate of the American Hospital Association, established in 1944. HRET’s mission is to transform health care through research and education. HRET provides free Web conferences and trainings at conferences and seminars to hospitals that wish to use AHRQ patient safety tools.

    4. Overview of Presentation Review context for congressional action and key policy changes to reduce readmissions in the Patient Protection and Affordable Care Act (ACA). Describe support now available to help hospitals respond to heightened concern and financial pressures. Review proven strategies for your use in customizing your change package to suit your hospital’s needs.

    5. Studies of Rehospitalizations Nearly 20% of Medicare hospitalizations are followed by readmission within 30 days. 90% of rehospitalizations within 30 days appear to be unplanned, the result of clinical deterioration. MedPAC: 75% of readmissions preventable, adding $12 Bn/yr to Medicare spending. Only half of the patients rehospitalized within 30 days had a physician visit before readmission. 19% of Medicare discharges are followed by an adverse event within 30 days—2/3 are drug events, the kind most often judged “preventable.”

    6. Congressional Action in Health Reform to Address Avoidable Readmissions Public reporting of all-payer readmission rates for targeted conditions. Penalties will be imposed on hospitals with “excess” readmissions (above expected rates) for targeted conditions, starting October 1, 2013. Sole community hospitals, Medicare-dependent small rural hospitals, low volume conditions are exempt.

    7. Geographic Variation in Hospital Readmissions

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