July 31--A new program in Eau Claire and Chippewa counties intended to keep Medicare patients recently released from hospitals from returning is receiving statewide attention.
That's partly because the transition intervention program appears to be working, but also because of a looming deadline from the federal Affordable Care Act that will penalize hospitals with high readmission rates. Those penalties are scheduled to begin in October 2013.
Medicare is a national health insurance program for Americans ages 65 and older and those younger than 65 with certain disabilities.
"We're kind of getting the ball rolling before it all takes effect," said Miranda Hotter of the Aging and Disability Resource Center of Eau Claire County.
The program aims to make sure recently discharged patients are able to care for themselves before being released from the hospital.
"It's a lot of coaching. It's a lot of self-management for the individual," Hotter said.
The Affordable Care Act imposes penalties on hospitals that have relatively high rates of readmission for Medicare patients within one month of their being discharged. The act is an attempt to address concerns about the number of hospital readmissions.
Last year Mayo Clinic Health System and Sacred Heart Hospital, both in Eau Claire, and St. Joseph's Hospital in Chippewa Falls approached the Aging and Disability Resource Center about putting a transition program into effect. The center uses a model developed by the University of Colorado that involves a home visit soon after patients are released, with follow-up calls during the first month patients are out of hospitals, which identify patients with a high risk of readmission.
"It's a lot of coaching. It's a lot of self-management for the individual," Hotter said. "The model that we use is actually in 36 other states and 13 countries. It's not a new program, It's just new to Wisconsin."
Mayo, Sacred Heart and St. Joseph's already have low readmission rates, but those hospitals are being proactive, Hotter said, by working with Chippewa and Eau Claire counties.
Pamela Foster, director of care coordination at Mayo Clinic Health System in Eau Claire, said the care transition program attempts to ensure patients understand aspects of their home care, such as taking medications properly, to help prevent their return to the hospital.
"What we're trying to focus on is potential preventable readmissions," she said.
During the first four months of the program, from February through May, more than 130 patients, participated according to Aging and Disability Resource Center statistics.
The center is receiving inquiries about the program from communities and medical providers around the state, Hotter said.
"We're getting emails, phone calls. We've done numerous presentations. It's definitely something people have on their minds," she said.
Knight can be reached at 715-830-5835, 800-236-7077 or email@example.com.
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