Blue Cross and Blue Shield of Illinois and the Illinois Hospital Association have launched Preventing Readmissions through Effective Partnerships, an initiative aimed at reducing hospital readmissions.
The PREP program comes at a time when Illinois' hospital readmission rates are among the worst in the nation, according to a 2009 report from the Commonwealth Fund. That report ranked the state 44th in Medicare 30-day readmissions at 20.3 percent; two years earlier, the state's readmission rate was 19.6 percent.
"The PREP initiative represents a remarkable opportunity to disseminate evidence-based approaches to hospital care that enhance quality, increase patient satisfaction and reduce costs," said Mark Williams, MD, professor and chief of the Division of Hospital Medicine at Northwestern Memorial Hospital, who will spearhead the program. Williams is also a principal investigator for Project BOOST, a program of the Society of Hospital Medicine aimed at improving the transition of patients from hospital to home care.
[See how improved quality of care, including reducing readmissions can affect a hospital's bottom line: Texas hospital saves $2.8M with quality improvement program]
More than 200 hospitals in the state have committed to the PREP program, which is scheduled to run through 2014, with the ultimate goal of raising the state's ranking from the bottom quartile to the top quartile of state rankings.
"This collaboration leverages IHA's experience and relationships with hospitals, the expertise of the academic community and resources from BCBSIL," said Scott Sarran, MD, BCBSIL's vice president and CMO. "We expect this collaboration to have a positive impact on improving the way hospitals, physicians and other healthcare providers transition patients to outpatient care in the community. We believe investing resources to improve transitions of care will have major payoffs in costs and quality."
The PREP program will focus on five key initiatives:
- Redesigning hospital discharge processes;
- Improving transitions of care;
- Developing and improving palliative care programs;
- Reducing readmissions from infections; and
- Measuring reductions in readmissions using standardized metrics.
A vital component of PREP will be patient education and assessing a patient's unique needs before the patient leaves the hospital. Hospitals will be tasked with making sure patients have the information they need to ensure a smooth transition. This includes developing standard discharge pathways that highlight medications, follow-up, pending tests, self-management instructions and goal-setting.
Under PREP, participating hospitals will take specific actions to reduce readmissions and employ a standard approach to discharge planning, which is critical to addressing the readmissions issue, as well as focusing on reducing infections. BCBSIL and IHA will provide hospitals with financial support, technical assistance, strategic approaches, tools and other resources.
Included in this are resources and training for hospital staff in a variety of programs, including Project BOOST, the Illinois Transitional Care Consortium's Bridge program, Northwestern's Training on Palliative Care and Goals of Care and The Agency for Healthcare Research and Quality's Project RED (Re-Engineered Discharge).
[Learn more about Project BOOST: California project seeks to halt hospital readmissions]
"The Illinois hospital community has long been committed to quality improvement and patient safety, and Blue Cross and Blue Shield of Illinois has been a strong advocate for improving the lives of its members," said Maryjane A. Wurth, the IHA's president. "This partnership is an outstanding example of how the provider and payer communities can work together to transform healthcare in Illinois."