Maintaining
patient health after
a hospital stay…
…So We All
Sleep More
Peacefully.
RARE Action Day
October 18, 2011
Statewide Triple Aim Goals
• Population health
– Prevent 4,000 avoidable readmissions within 30 days of
discharge OR, in other words,
– Reduce overall readmissions rate by 20% from 2009 base
by 12/31/12
• Care experience
– Help patients and their families spend 16,000 more nights
in their own beds instead of in the hospital
– Improve by 5% on HCAHPS survey questions on
discharge
• Affordability of care
– Save an estimated $30 million for commercially insured
patients; additional savings for Medicare patients
Broad Community Support
• Campaign Operating Partners Role
– Design and lead the effort, manage operations,
coordinate partner and stakeholder involvement,
and support, and provide the majority of staffing
and resources to support participating hospitals
• Institute for Clinical Systems Improvement (ICSI)
• Minnesota Hospital Association (MHA)
• Stratis Health
Broad Community Support
• Supporting Partners Role
– Provide resources and support to develop and
implement specific aspects of the campaign
• Minnesota Medical Association
• MN Community Measurement
• Community Partners Role
– Endorse and actively support the campaign
• A growing list of providers, health plans, state health
agencies, home health agencies, nursing homes,
patient advocacy groups and other community
organizations
Why Is Campaign Needed?
• Almost 20% of Medicare patients in Minnesota are
•
•
•
•
readmitted within 30 days of discharge
Great opportunity to improve care delivery by
correcting gaps in fragmented system
Reduce unnecessary burden on patients, families
Preventable readmissions are contributing to
unsustainable climb in health care costs
CMS penalties for low-performing hospitals – “clock”
began ticking Oct. 1, 2011
RARE Overview Video
Five Key Areas
•
•
•
•
•
Comprehensive discharge planning
Medication management
Patient and family engagement
Transition care support
Transition communications
Participating Hospital Requirements
– Commit to specific readmission
reduction goals set based on MHA
analysis
– Conduct an organizational assessment
of its readmissions
– Commit to improving performance in key
areas
– Agree to publicly disclose participation
in the campaign
Support for Participating Hospitals
– RARE Resource Consultant assigned to
each hospital
– Work with hospital on analysis to identify
key improvement areas
– Assist in selecting and implementing
interventions most likely to accelerate
their work and achieve success
Support for Hospitals
•
•
•
•
•
•
•
•
Learning collaborative options
Best practice toolkits
Face-to-face sessions
Webinars
Conference calls
Networking opportunities
Data reporting
“Innovator” approach: intensive, rapid
process improvement work
Analysis and Measurement
• MHA data for establishing individual hospital goals
– Hospitals receive quarterly Potentially Preventable
Readmissions (PPR) data from MHA
• Hospitals collect data on variety of process
measures; report their progress
• CMS Hospital Compare readmission measures
monitored over time
• 30-day all cause readmission rates for select clinical
conditions will be publicly reported on Minnesota
HealthScores for hospitals and provider groups in
2012
Campaign Timeline
August/September
Hospitals commit to participation
September/October
Hospitals complete organizational assessment
and identify key opportunities for improvement
October 31, 2011
Learning collaborative
agreements/applications due
October/November 2011
Hospitals identify key opportunities and launch
improvement activities
Ongoing
Toolkits, webinars, networking opportunities,
resource consultant support, optional learning
collaboratives
Quarterly
PPR data reports provided by MHA
Through Dec. 31, 2012
Improvement work, measurement continues
16,000 nights at home…
Together we can make a difference
for patients in Minnesota
Thank you for
helping everyone sleep
more peacefully.
Questions?
For more information:
• Kathy Cummings kathy.cummings@icsi.org
• Tania Daniels tdaniels@mnhospitals.org
• Karla Weng kweng@stratishealth.org
www.RAREreadmissions.org