Alliance Concurs With Berwick Policy Priorities of Reducing Unnecessary Hospital Readmissions, Continuing to Improve Nursing Home Care Quality

WASHINGTON, July 7 /PRNewswire-USNewswire/ -- Commenting on the fact Dr. Donald Berwick will be serving as Administrator of the Centers for Medicare and Medicaid Services (CMS), the Alliance for Quality Nursing Home Care today said it concurs with several of the health care policy objectives outlined by Berwick, and specifically cited reducing unnecessary hospitalizations and continuing to improve nursing home care quality as two key areas in which the Alliance intends to work closely with CMS to help make progress for the benefit of U.S. seniors.

"We are pleased Dr. Berwick has specifically cited as a CMS priority the need to help reduce unnecessary hospital readmissions, and building on the progress we have made together to improve the quality of U.S. seniors' rehabilitative and nursing home care," stated Alan G. Rosenbloom, President and CEO of the Alliance. "Finding and developing new policy strategies to reduce hospital readmissions will not just help sustain quality improvements across our entire care continuum, but also help maximize cost efficiencies. We intend to work closely with Dr. Berwick and Congress to help advance these vital twin objectives."

The Alliance leader noted that while nursing homes are only part of the rehospitalization picture, "the nature of their patients and the confluence of payers make it a critical environment for policymakers to examine as they seek solutions that both benefit patients and reduce health care costs." He pointed to a recent installment of the Alliance for Quality Nursing Home Care's "Care Context" series of health policy analyses finding three primary drivers of rehospitalization following a stay at a Skilled Nursing Facility (SNF) are: regional differences in care practices, variable provider Medicaid rates, and a lack of adequate coordination and payment incentives across the spectrum of care.

Avalere Health helps conduct the underlying research, analysis and literature review for the Alliance's Care Context health policy series, and the recent installment, entitled, "Rehospitalizations From Skilled Nursing Facilities: A Multifaceted Issue That Calls For Innovative Policy Solutions," identified three potential areas of focus for policymakers:

Understand regional differences -- Rehospitalization rates range from a low of 15.1 percent in Utah to a high of 28.2 percent in Louisiana;

Study influence of higher Medicaid rates -- Previous studies show that a $10 increase in the daily Medicaid rate above the state average correlates with a 5 percent lower chance of hospitalization;

Explore successful models of care coordination that align incentives -- Some models for care coordination have proven successful in boosting quality outcomes and reducing costs; these could be expanded specific to the nursing home population.

"The Alliance will continue to be active in promoting constructive policy ideas designed to sustain ongoing improvements in quality across the spectrum of care, and which also help federal lawmakers achieve savings in health care expenditures," Rosenbloom said. "The growing interrelationship and interdependence between care settings – and our Medicare and Medicaid payment systems themselves – are phenomena that demand continued study, research, and ultimately, solutions."

SOURCE The Alliance for Quality Nursing Home Care