CMS' quality improvement efforts positively impact hospitalization rates

Care transition programs seem to be working. In communities where the Centers for Medicare & Medicaid Services (CMS) piloted quality improvement initiatives aimed at coordinating care for recently discharged Medicare patients, there were significant declines in rates of 30-day rehospitalizations and all hospitalizations, according to research published Jan. 23 by the Journal of the American Medical Association.

“Many Medicare beneficiaries have serious illnesses and disabilities and receive services from multiple clinicians and healthcare settings, engendering risks of errors in transitions and rehospitalizations,” wrote lead author Jane Brock, MD, MSPH, chief medical officer for the Colorado Foundation for Medical Care. In recent years, CMS has assigned various healthcare entities in different geographic regions the task of piloting quality improvement initiatives as designated quality improvement organizations.

To learn whether the strategies employed by the quality improvement organizations worked, researchers examined the rate of rehospitalizations and hospitalizations among Medicare beneficiaries in 14 intervention communities during a pre-implementation period from 2006 to 2008 and during an implementation period from 2009 to 2010. They also examined rehospitalization and hospitalization rates in 50 control communities during the same time frame.

They determined that in the 14 intervention communities rehospitalizations declined by an average of 5.74 percent and that hospitalizations declined by an average of 5.70 percent from the pre- to post-implementation periods. In the 50 control communities, rehospitalizations and hospitalizations declined by an average of 2.05 percent and 3.17 percent, respectively.

“The CMS quality improvement organization initiative demonstrated that Medicare beneficiaries in communities in which quality improvement initiatives were implemented to promote evidence-based care transitions, compared with Medicare patients in communities without quality improvement interventions, had lower 30-day rehospitalization rates per 1,000 and hospitalization rates per 1,000,” Brock et al concluded.