iLoveBenefits: Industry News Blog

Hospital at Home model gains steam

Hospital at Home model gains steam as Mt. Sinai program cuts costs, readmissions

Monday, June 6, 2016 | By Zack Budryk

Cutting readmissions and reducing medical errors, the nation’s third-leading cause of death, are among the healthcare industry’s top priorities, and the secret to solving both may be stepping up home care, according to Oregon Public Broadcasting.

Nearly two years ago, New York’s Mt. Sinai Hospital premiered the Mobile Acute Care Team (MACT) program. This pilot program aims to deliver hospital-quality home care for patients who are at high risk for readmission. So far, the ongoing pilot has cut costs by nearly 20 percent, according to the article, while also reducing an unspecified percentage of readmissions and delivering high patient satisfaction.

Under the program, Mt. Sinai partners with community institutions such as Visiting Nurse Service of New York to provide home treatment for such conditions as chronic obstructive pulmonary disease (COPD), congestive heart failure, diabetes and urinary tract infections, according to a blog post from the hospital. “This is a real paradigm shift in medicine,” Mt. Sinai’s Linda DeCherrie, M.D., told OPB.  People will often say on first glance, ‘That sounds so great that we should definitely do that,’ but when you really get into it, it’s a totally different way of providing care.”

Medicare’s refusal to cover hospital-at-home services has kept many such programs from getting off the ground, but the Center for Medicaid & Medicaid Services’ Innovation Center awarded the MACT project $9.6 million in 2014 as part of its second round of Health Care Innovation Awards.

Nor is the MACT program the only example of such a program working; an internal analysis of the Humana At Home care management service found it cut hospitalizations among participants 45 percent while boosting survival rates, according toOpen Minds. Those Hospital at Home programs that have demonstrated consistent success have been connected to primary- and palliative care programs as well as disease-management programsFierceHealthcare previously reported.

To learn more: – read the OPB article – here’s the Mt. Sinai blog post – read the CMS announcement – check out the Open Minds post

Related Articles: How to make Hospital at Home programs work How transitional care cuts readmission risk First Medicare-approved transitional care center opens for business Readmission reduction solution: House calls How hospital-community partnerships can boost population health ER overcrowding solution: Community paramedicine

The move to outpatient care . . . not so fast

According to a recent analysis of Medicare data from between 2008 and 2011, researchers found that one extra day in the hospital:

  • Reduced mortality risk for patients treated for pneumonia by 22%
  • Reduced mortality risk for heart attack patients by 7%
  • Reduced readmissions for severe heart failure patients by 7%
  • Saved five-to-six times more lives compared with outpatient care

Source: “ONE EXTRA DAY IN THE HOSPITAL CUTS READMISSION RATES AND REDUCES PATIENT DEATHS,” Columbia Business School Press Release, October 28, 2014, http://www8.gsb.columbia.edu/newsroom/newsn/3251/one-extra-day-in-the-hospital-cuts-readmission-rates-and-reduces-patient-deaths  

Care coordination yields better outcomes

Care coordination yields better chronic disease outcomes, study finds
Even modest improvements in care coordination could fuel a decline in hospital admissions, complications and use of emergency medical services among older people with chronic conditions, according to a study published in the journal JAMA Internal Medicine. The study, which involved almost 300,000 Medicare patients with type 2 diabetes, emphysema or congestive heart failure suggests that improvements in coordination of care for elderly patients could help Medicare save as much as $1.5 billion annually. HealthDay News (3/17)

We are making progress and there are opportunities for improving health care quality and reducing health care disparities

This from my colleague and friend, Carolyn Clancy

Colleagues, I am pleased to announce that today AHRQ released our 2011 National Healthcare Quality Report and National Healthcare Disparities Report that show the progress and opportunities for improving health care quality and reducing health care disparities.

 The reports (at www.ahrq.gov/qual/qrdr11.htm) are designed to inform discussions among policymakers, elected officials, health care leaders, and others so they can take steps to address gaps in quality care and access to services.

 Every American should be able to receive safe and appropriate health care to help them achieve their best possible health.  While the reports show progress, such as in cardiovascular care, more work is needed to address persistent gaps in quality and access for many Americans. Overall, health care quality continues to improve at a slow rate of 2.5 percent across the measures tracked.

 Based on the approximately 250 health care measures shown in the reports, Americans on average received appropriate acute care services 80 percent of the time, recommended chronic disease management services 70 percent of the time, and preventive care services 60 percent of the time.

 New features in the 2011 National Healthcare Quality Report and National Healthcare Disparities Report include data on the adoption of electronic health record systems in hospitals as well as home health and hospice agencies, adolescent health, and musculoskeletal diseases such as arthritis and osteoporosis. 

 Thank you for your continued support as we work together to help improve access to and quality of health care for all Americans.

Patients with chronic heart failure benefit from stem cell injections

German scientists found that patients with chronic heart failure showed long-term improvement in ventricular function and survival after receiving injections of bone marrow stem cells derived from their pelvis. “Our study suggests that, when administered as an alternative or in addition to conventional therapy, bone marrow cell therapy can improve quality of life, increase ventricular performance and increase survival,” said the lead researcher. Reuters (8/29)