Not time to pull the plug on hospital readmissions program ... yet
James M. Berklan
It's hard to sit on one's hands when caregiving issues are in play. Yet, that's exactly what I'd recommend with regard to at least one initiative aimed at lowering hospital readmissions.
That way all camps monitoring what has become a contentious project could have more kindling for their bonfires.
More time is needed, frankly, before the Community-based Care Transitions Program (CCTP) can be labeled either a success or a failure. To jump in either direction at this point would be premature.
On Thursday, we ran a news story that had one of those delicious headlines that could be read several ways: “Federal money has not yet made a big difference in reducing hospital readmissions, report states.”
Those in favor of this Obama-administration promoted program latch onto the “not yet” aspect of the headline. As if success were an inevitability.
Those opposed to what they see as yet another over-extension of the federal government, however, can emphasize the “HAS NOT” part of the headline. As in, “It ain't working!”
For those in the middle? Well, they can grab onto “big,” as if to say the funds are making a difference, just not a BIG one ( … yet?).
All three camps need to give this one some time to show its real character. Will this extra money being used for post-discharge support services make a difference? Time should tell.
More than three-fourths of the community organizations taking part in the Center for Medicare and Medicaid Innovation program have partnered with at least one nursing facility, home health agency or other non-hospital entity. The cause for concern is that only about 10% of these partnerships reported significantly reduced hospital readmissions.
This, however, could be a bit misleading because the Econometrica report can hardly be described as definitive. It is more like a progress report, and subsequent filings will tell the real story. (Note: The report is dated May 30, 2014 but was posted on the Department of Health and Human Services website only earlier this month.)
The report was written using 2012 data. That means not all participants were even enrolled in the project at the time, and some had only a few months' worth of results ton contribute. That's hardly justification for planting a final grade on it.
But the idea of using this report as a baseline, from which to measure successes or failure, is a good one. Other pilot programs and rehospitalization-reduction initiatives are underway, in various forms and locations. Whether they can help lower readmit rates by gradually changing behaviors, or better educate staff, residents and their family, members remains to be seen.
It's understandable that Congress will want to birddog this Affordable Care Act outgrowth, especially now that both of its chambers are controlled by factions that oppose Obama.
They'll make sure an endless supply of federal funding doesn't get pushed into CCTP without merit. And in due time, they'll have the numbers — truly useful, worthy numbers — to prove their case. Or their opponents will.
James M. Berklan is McKnight's Editor. Follow him @JimBerklan.