This type of program, for which intensiveness is scaled based on a severity or risk profile, was used moderately to hospitalwide in more large (400 or more beds) and urban hospitals than in small (0–99 beds), medium (100–399 beds) and rural organizations, according to the 2011 American Hospital Association Annual Survey. Other care coordination strategies include assigning case managers to patients at risk for hospital admission or readmission for outpatient follow-up, which half of survey respondents reported using moderately to hospitalwide, and prospective management of patients at high risk for poor outcomes or extraordinary resource use by experienced case managers, which 56 percent of hospitals reported using moderately to hospitalwide.
Beginning on Oct. 1, 2012, Medicare began penalizing hospitals for too many readmissions within 30 days of discharge for heart attack, heart failure and pneumonia. Continuity-of-care programs, including those above, can be effective ways to reduce readmissions.
For more information on AHA data, call 866-375-3633.
Coming in February: Medical Homes
These team-based models are designed to improve continuity of care. We will look at how many hospitals have established one.