Medicaid Medical Directors-led Hospital Readmissions Study Sheds Light on Hospital Readmissions
In conjunction with AcademyHealth and with funding support from the Agency for Healthcare Research and Quality (AHRQ), Medicaid Medical Directors (MMDs) sought to better understand Medicaid readmissions and state-level efforts to address this issue. The study found that 30-day Medicaid readmissions rates for the 19 participating states varied from 5.5 percent to 11.9 percent, with an average of 9.4 percent. State Medicaid payments for readmissions were substantial: they averaged $77 million per state for study states, and they represented 12.5 percent of the payments for all Medicaid hospitalizations. Five diagnostic groups appeared to drive Medicaid readmissions, accounting for 57 percent of readmissions and 49 percent of hospital payments for readmissions. This study offers valuable new information about Medicaid hospitalizations: it allows MMDs to better understand the nature and prevalence of hospital use in the Medicaid population and provides a baseline for measuring improvement.
The article, "Medicaid Admissions and Readmissions: Understanding the Prevalence, Payment, And Most Common Diagnoses" can be found here: http://content.healthaffairs.org/content/33/8/1337.abstract
New Publication Shares How Six States are Integrating Care Coordinators to Help Manage the Care of Children with Special Needs
Care coordination, broadly defined as “the deliberate effort of health care providers to facilitate and organize the appropriate delivery of health care services for a patient,” is a key element of high-quality care and can lead to greater caregiver satisfaction and cost savings. Therefore, it is important for states to find effective ways to support care coordinators.
A new
Evaluation Highlight titled, "
How are CHIPRA quality demonstration States supporting the use of care coordinators?," discusses how six states have integrated care coordinators to help manage the care of children with special health care needs and children at risk for poor health because of socioeconomic factors. The six states (Alaska, Idaho, Massachusetts, Oregon, West Virginia, and Utah) share how they support pediatric practices’ use of care coordinators by providing training, technical assistance, and/or funding as practices implement patient-centered medical home models.
This
Highlight can help other states seeking to use care coordinators as an integral part of their strategy for achieving functions of care coordination in primary care practices serving children and adolescents.
Involving stakeholders in quality improvement (QI) initiatives can help ensure that the initiatives are implemented effectively, achieve intended outcomes, and contribute to sustainable changes in the quality of child health care.
A new Implementation Guide titled, "
Engaging Stakeholders to Improve the Quality of Children’s Health Care," provides steps and tips for state officials and other program administrators on how to engage and partner with stakeholders in child health care QI initiatives. This Implementation Guide, from the CMS-funded national evaluation of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program, focuses on stakeholder engagement efforts in Georgia, Idaho, and Massachusetts.
The
Implementation Guide provides a five-step approach to engaging stakeholders, breaking down each step into smaller tasks with key points and resources to consider throughout the process.
Under a contract with the Agency for Healthcare Research and Quality (AHRQ), Mathematica Policy Research is partnering with AcademyHealth and the Urban Institute to lead the national evaluation of the CHIPRA quality demonstration grant program.
