Improving Care Transitions for Patients

Partner Acting: Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) is working with Quality Improvement Organizations (QIOs) in 14 communities across the nation on a pilot program aimed at reducing readmissions and easing care transitions as patients go from the hospital to home. According to a 2007 MedPac report, Medicare wastes nearly $15 billion annually treating patients who are discharged and, because of poor care coordination, suffer an adverse event and must be readmitted. But by sharing best practices proven to succeed at the local level, communities will be able to design solutions to tackle root causes of readmissions.

The QIOs working with the local communities will provide support in implementing:

  • hospital and community system-wide interventions;
  • interventions that target specific diseases or conditions; and
  • interventions that target specific reasons for admission.

CMS will monitor progress by watching patient readmission rates in the 14 communities. You can track the progress of the Care Transitions project online.

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“The National Priorities Partnership is a unique effort that has identified a set of national priorities, developed by multistakeholder leadership, to help focus resources aimed at improving healthcare quality and patient safety.”

Mark R. Chassin, The Joint Commission