Acumentra Health and four supporting partners have launched No Place Like Home, a statewide campaign to reduce avoidable hospital readmissions. The Campaign coordinates activities, training, and data initiatives in multiple care settings; the aim is to support readmissions initiatives by avoiding the burden of multiple data collection requirements for overlapping projects. In particular, the campaign aligns Medicare project work with the Partnership for Patients (PfP) initiatives for hospitals; Acumentra Health is working closely with the Oregon Association of Hospitals and Health Systems, which leads PfP initiatives for the majority of Oregon hospitals.
No Place Like Home has been implemented by QIOs in four other states, with several others currently adopting it. Oregons No Place Like Home website incorporates content developed by several other states, as well as resources collected by Acumentra Health.
Visit the No Place Like Home website to join the Campaign and access free resources.
As Medicares Quality Improvement Organization (QIO) for Oregon, Acumentra Health convenes the Care Coordination Coalition (CCC) to facilitate communication and joint improvement activities aimed at reducing avoidable hospital admissions. The CCC coordinates activities within Oregon communities, engaging providers, patients, and stakeholders through a learning and action network (LAN) approach. Coalition activities are shaped by community needs and planned to align and coordinate with other ongoing projects, with the ultimate goal of developing a sustainable, community-led approach for improving care.
The CCC is part of a national effort by the Medicare QIO Program to coordinate community-based, cross-setting work to integrate patient care and reduce unnecessary hospital admissions. Nationally, nearly 1 in 5 Medicare patients discharged from a hospital is readmitted for hospital care within 30 days; readmissions are reported to have cost Medicare $26 billion over 10 years. The CCC has access to tools tested during a 13-state QIO pilot program, including approaches based on effective communication, coordination between settings, and activation of patients and caregivers to handle appropriate issues without hospital visits.
CMS project overview (PDF)
Acumentra Health assisted community organizations in applying for project funding under the federal Community-based Care Transitions Program (CCTP), a demonstration project that aims to reduce hospital readmissions, test sustainable funding streams for care transition services, maintain or improve quality of care, and document measureable savings to the Medicare program.
National Coordinating Center for
the Integrating Care for Populations and Communities Aim
Comprehensive support for communities developing transitional care programs, including a toolkit of analysis and intervention materials, recorded webinars, and model documents created during the pilot program. The website is hosted by the Colorado QIO (CFMC), which led the pilot program and coordinates the current national project.
Home Health Quality Improvement National Campaign
Access to tools requires free registration as a campaign participant, other provider, or campaign supporter; see links at top of BPIP page.
Institute for Healthcare Improvement
This search widget is optimized to look for high-quality content on improving care transitions and patient safety. Enter a search term and click the "Search" button. The results will appear with tabs at the top to help you filter your results for content on specific issues as they relate to your search. The widget was developed by Dr. Joanne Lynn and colleagues at Altarum Institute. For more information and free web code, visit MediCaring.org.
Last updated March 20, 2013