CMS to pay $2.3M for help reducing hospital readmissions

By Industry News Release
09:25 AM

The Centers for Medicare & Medicaid Services has selected The Lewin Group to help reduce the number of hospital readmissions for Medicare beneficiaries, and improve quality and outcomes when patients transition from hospitals to other settings, such as their homes or long-term care facilities.

CMS awarded The Lewin Group, an OptumInsight company, $2.3 million for the first year of a 5-year program to assist hospitals and community-based organizations participating in the Community-based Care Transitions Program (CCTP). The program’s goals include: improving the transition of Medicare beneficiaries from inpatient hospitals to home or other care settings; improving the quality of care; reducing hospital readmissions for high-risk beneficiaries; and achieving measurable savings for the Medicare program, the nation’s federally-funded health insurance program for Americans 65 and older.

The Medicare Payment Advisory Commission (MedPAC) estimates that the cost to Medicare for readmissions to hospitals is about $15 billion, of which as much as $12 billion is thought to be preventable through improved care. The federal Partnership for Patients, a new public-private initiative, will provide funding for care transition services delivered to high risk Medicare beneficiaries, a service that is not currently reimbursable under the Medicare program. Successful care transitions are expected to save the Medicare program billions of dollars over the next several years.

The CCTP provides funding to test models for improving care transitions for high-risk Medicare beneficiaries as part of the Partnership for Patients initiative, whose goal is to reduce readmissions to hospitals by 20 percent by 2013. This would mean preventing approximately 1.6 million readmissions that CMS estimates are avoidable.

The Lewin Group and its team will provide technical assistance and guidance for an estimated 500 community based organizations (CBOs) and hospitals expected to be involved in the project. Lewin will gather best practices through site visits and facilitate peer to peer information sharing through online collaboration and national meetings. The Lewin Group’s team includes the Colorado Foundation for Medical Care, the University of Colorado, Seamon Corporation, 371 Productions and ON24.