Comprehensive care plans that are tailored to individual Medicare patients with chronic conditions and monitored by a care coordinator can reduce hospital readmissions by up to 34 percent, according to a report by Mathematica Policy Research, Inc. on behalf of the National Coalition on Care Coordination.
The report examines the three types of care plan interventions that have been tried and the success rate of the Medicare Coordinated Care Demonstration, which began in 2002. It outlines the attributes of the interventions that have been effective, such as in-person contact with patients, coaching patients on proper care and medication use, frequent communication between care coordinators and primary care physicians, and assigning each patient to a nurse care coordinator.
Currently, however, hospitals have no incentive to reduce readmissions under Medicare’s Inpatient Prospective Payment System and, therefore, have no interest in participating in comprehensive care plans. The report, which says that care coordination is vital to keeping Medicare solvent, advocates enticing hospitals to participate in care plan interventions by paying hospitals that have below-average 30-day readmission rates a higher base rate for all Medicare admissions and paying hospitals with high readmission rates a lower base rate. The rates would be “appropriately risk-adjusted and set so that total Medicare payments to hospitals are equivalent to those that would have been achieved with a declining national readmission rate.”
Read the executive summary or full report.
