Newswise — America's Healthy Future Act, the health reform bill now under review by the Senate Finance Committee, includes funding to pilot the wide scale implementation of a patient-centered care transition model that has successfully reduced hospital readmission rates by 35 to 50 percent. Eric A. Coleman, MD, MPH, professor of medicine at the University of Colorado, developed the Care Transitions Intervention to address the high rate of Medicare hospital readmissions. Currently, one in five patients returns to the hospital within 30 days, costing Medicare over $17 billion annually.
The John A. Hartford Foundation has supported the development, research, and dissemination of the Care Transition Intervention program with $3.2 million in grant funding since 2000. Care Transitions helps patients assume a more active role in ensuring their health care needs are met and regain their independence after hospitalization.
“The Hartford Foundation is a committed champion of programs that improve the health and well-being of older adults,” said Corinne H. Rieder, executive director of the Hartford Foundation. “A national roll-out of this program will have a positive impact on health care by demonstrating improved quality of care for many older adults, while lowering costs.” The Hartford Foundation first awarded $1.2 million to Dr. Coleman and his team in 2000 to develop and test the Care Transitions Intervention, a self-management program that helps patients take an active role in their care following a hospital admission. The model includes a transition coach who works with patients and their caregivers to help them manage multiple prescriptions, follow post-hospital recommendations, and present providers with the information they need to be effective (for more information go to www.caretransitions.org). When practiced successfully, the program helps patients avoid uncoordinated and fragmented care, prevents hospital readmissions, and reduces the cycle of continued costs and care that follows. In 2005, and again in 2008, the Hartford Foundation awarded a combined total of nearly $2 million in additional funding to support the dissemination of the program on a national scale. Over 160 hospitals and health care systems have already adopted the model.
America's Healthy Future Act provides funding to establish a Community Care Transitions Program. In the proposed three-year pilot program, Medicare will fund partnerships between hospitals and community-based organizations to provide transitional care services to Medicare beneficiaries at the highest risk of preventable re-hospitalization.
Hospitals with readmission rates above the 75th percentile would be eligible to participate, and preferences would be given to hospitals that serve medically underserved populations, as well as rural and small community hospitals. The program’s proposed funding level would be set at $500 million over three years.
- About the John A. Hartford Foundation -Founded in 1929, the John A. Hartford Foundation is a committed champion of training, research, and service system innovations that promote the health and independence of America's older adults. Through its grantmaking, the Foundation seeks to strengthen the nation's capacity to provide effective, affordable care to this rapidly increasing older population by educating "aging-prepared" health professionals (physicians, nurses, social workers), and developing innovations that improve and better integrate health and supportive services. The Foundation was established by John A. Hartford. Mr. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic and Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950's. Additional information about the Foundation and its programs is available at www.jhartfound.org.
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