As part of The Centers for Medicare & Medicaid Services effort to dramatically reduce hospital readmissions by 2013, the agency has announced 23 new organizations that will participate in its Community-based Care Transitions Program (CCTP).
CCTP is a program targeted to high-risk Medicare beneficiaries to provide them with the added support after hospital discharge as they move to new care settings including skilled nursing facilities and their own homes. The new organizations join the initial seven community-based organizations accepted into the program last year.
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In total the new CCTP members will provide support services to more than 223,000 Medicare members and 126 hospitals in 19 states across the country.
"We are very excited to have these 23 sites join our efforts to improve opportunities for patients to continue to make gains after they leave the hospital," said Marilyn Tavenner, CMS Acting Administrator, in a press release. "I've seen the very real difference that support from organizations like our partners in the Community-based Care Transitions Program can make to people's post-hospital care and their health."
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Participants in the CCTP join the program for two years and are paid a flat fee to provide care coordination services for high-risk Medicare patients after hospital discharge. The program was created under the Affordable Care Act, which provided $500 million of funding over five years to establish the program. With new CCTP additions, CMS has now committed roughly half of those funds and it continues to accept applications from community-based organizations interested in being part of the CCTP.
CMS officials are clear, however, that the funding organizations receive to participate in CCTP is not a one-time grant and want to be clear on that point to any other potential applicants.
"This is not a grant, it's not a contract, this is an opportunity to price a payment benefit and to receive that payment benefit as Medicare patients are served through this program," Dennis Wagner, co-direct of the CMS Center for Medicare and Medicaid Innovations told potential applicants in a conference call last November. "…it's got to add up. That is to say that the cost of that benefit when applied to the patients who received it, have to generate more savings than they do in cost. So that's really key to successful application."
According to the CCTP website at healthcare.gov, program applicants must:
- Identify community-specific root causes of readmissions and define their target population and strategies for identifying high risk patients;
- Specify care transition interventions that will impact the root causes identified, which may include strategies for improving provider communications and improving patient activation;
- Describe how care transition strategies will incorporate culturally appropriate and effective care transition beneficiary-centric approaches to ethnically diverse beneficiaries, and how other community and social supports and resources will be incorporated to enhance the beneficiaries' post-hospitalization management outcomes;
- Provide an implementation plan with milestones;
- Provide a clear budget proposal, including a per eligible discharge rate reflecting direct costs for care transition services (this program differs from a grant program in that it will not pay for administrative overhead and infrastructure costs);
- Demonstrate prior experience, including successes and failures.
CCTP is part of the Partnership for Patients, a public-private partnership aiming to cut preventable errors in hospitals by 40 percent and reduce preventable hospital readmissions by 20 percent over a three-year period. Achieving these goals has the potential to save up to 60,000 lives, prevent millions of injuries and unnecessary complications in patient care, and save up to $50 billion for Medicare over ten years. To date, more than 8,000 partners have pledged their commitment to the aims of the Partnership for Patients, including more than 3,800 hospitals.