Hospital Medicine by Robert J. Habicht & Mangla S. Gulati

Author:Robert J. Habicht & Mangla S. Gulati
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Strategies and Programs to Improve Transitions of Care

To address this problem, several policy initiatives have been developed to identify, measure, and improve transitions of care . Starting in October 2012, the Centers for Medicare and Medicaid Services (CMS) instituted penalties to facilities with high readmissions rates within 30 days of discharge for three conditions: myocardial infarction, heart failure, and pneumonia. Two-thousand hospitals were penalized up to 1% of Medicare reimbursements in 2012. This reduction has increased by one percent each year with a cap at 3% in 2014 [6]. The Joint Commission enterprise joined an initiative to define methods to achieve effective transitions of care and created a Transitions of Care Portal to provide transitions of care resources [10, 11]. The CMS Community-based Care Transitions Program (CCTP) was created by the Affordable Care Act to test models for improving care transitions from the hospital and reducing readmissions for Medicare beneficiaries [12].

In 2007, the American College of Physicians, Society of Hospital Medicine, and Society of General Internal Medicine convened in a consensus conference to address the quality gaps in transitions of care . The Transitions of Care Consensus Conference (TOCCC), which had over 30 participating organizations including the Agency for Healthcare Research and Quality and the Centers for Medicare and Medicaid Services, developed consensus standards for these transitions for future implementation (Table 11.1) [13].Table 11.1Principles and standards for managing transitions of care

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