| Illinois Blues, Hospital Association Collaborate To Reduce Readmissions
Blue Cross and Blue Shield of Illinois (BCBSIL) and the
Illinois Hospital Association (IHA) are joining forces to reduce
Illinois hospital readmissions through a new quality initiative –
Preventing Readmissions through Effective Partnerships (PREP).
The parties are collaborating with experts from the
Division of Hospital Medicine at Northwestern Memorial Hospital and
Northwestern University Feinberg School of Medicine and the Society of
Hospital Medicine.
PREP will help Illinois hospitals significantly reduce
the rate of patient readmissions by 2014 through the following five key
initiatives:
- Redesigning hospital discharge processes;
- Improving transitions of care;
- Developing and improving palliative care programs;
- Reducing readmissions from infections; and
- Measuring reductions in readmissions using standardized metrics
BCBSIL expects to invest up to $1 million a year over the next four years to reduce preventable hospital readmissions.
"This partnership is an outstanding example of how the
provider and payer communities can work together to transform health
care in Illinois. PREP has great potential for both improving the
quality of health care and reducing costs," said Maryjane A. Wurth, IHA
president.
"We believe investing resources to improve transitions
of care will have major payoffs in costs andquality," said Dr. Scott
Sarran, the Blues CMO.
The Commonwealth Fund State Scorecard 2009 ranked
Illinois 44th in the rate of Medicare 30-day readmissions as a
percentage of admissions, with a rate of 20.3 percent, an increase from
19.6 percent in 2007. Nationally, the median is 17.5 percent.
So far, 201 Illinois hospitals have pledged to reduce
readmissions by the end of 2013 with the goal of raising the
state’s performance from the bottom quartile to an upper
quartile.
Dr. Mark Williams, chief of the Division of Hospital
Medicine at Northwestern, will be leading efforts to optimize the
transition of care for hospitalized patients through mentored
implementation.
"A critical component of PREP is patient education
– assessing what a patient’s unique needs are before going
home, then making sure they have the information they need to ensure a
smooth transition," he said.
Research published in the April 2009 New England Journal
of Medicine indicates that 1 in 5 hospitalized Medicare patients are
readmitted to the hospital within one month of discharge, with the
second hospitalization being more expensive than a comparable first
admission.
In 2009, there were more than 50,000 readmissions to
Illinois hospitals, with each patient spending, on average, five
additional days in the hospital. Sarran points out that improvement of
the Illinois readmission rate to the current national average has the
potential to save or avoid costs of approximately $150 million dollars
in the first year.
Addresses: Blue Cross and Blue Shield of Illinois, 300 East Randolph Street, Chicago, IL 60601-5099; (800) 654-7385, www.bcbsil.com. Illinois Hospital Association, 1151 East Warrenville Rd., P.O. Box 3015, Naperville, IL 60566; (630) 276-5400, www.ihatoday.org.
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