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March 7, 2014
NOTES FROM THE FIELD
"Doc Fix" and the Potential to Improve Readmissions 
By: Kristin Paulson, Senior Manager of Policy and Initiatives, CIVHC
There has been a lot of buzz lately about the "doc fix" or the proposed repeal of the Medicare Sustainable Growth Rate formula (SGR). The SGR was put into law in 1997 as part of an attempt to regulate Medicare spending and essentially linked physician Medicare reimbursement to an economic target. The formula turned out to be rather quirky and soon resulted in proposed reimbursement cuts of more than 5 percent per year. To counter unsustainable cuts to reimbursement levels, Congress began periodically issuing temporary fixes to postpone the cuts and maintain physician reimbursement levels. Over time, the cuts dictated by the SGR have continued to grow and this past January physicians were looking at a potential cut in Medicare reimbursement of more than 20 percent.
Upcoming Healthy Transitions Webinar:

Care Transitions and Health Information Exchange

Join Pamela Russell from the Colorado Regional Health Information Exchange for an update on HIE progress in the state, including which hospitals, labs, and long-term and post-acute care organizations are participating. Learn about Direct messaging and how it's being used to improve care transitions from skilled nursing homes to an Emergency Department in one community up north. 

IN THE NEWS
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When Readmission Programs Fail, What's Next?
From Becker's Hospital Review, 1.2.2014

Failure can be a daunting prospect in any situation, but especially in readmissions when significant dollars may be on the line. Learning 

to take the good from an experience and apply it to the next venture, however, can be the key to creating truly patient-centered coordination programs that succeed on many fronts.

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CMS delays 'two midnight' rule until after Sept. 30
By: Joe Carlson
From Modern Healthcare, 1.31.2014

On January 31st, CMS announced it would be delaying the implementation of the new two-midnight rule until October, 2014. The rule has come under sharp scrutiny by health systems, hospitals and physicians, but CMS was clear that this was a just a delay in implementation and it would continue to move forward with the rule this fall.

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Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare 
By: David C. Grabowski and A. James O'Malley, Health Affairs, 2.2014
A recent study by the Commonwealth Fund looked at the effect of an after-hours telemedicine program on the hospitalization rates of nursing home residents. Participating nursing homes saw a significant decrease in hospitalizations, but because of the current payment structure, the benefits of decreased readmissions were primarily seen by Medicare and not the nursing homes themselves.
A Hidden Cause of Readmissions Comes to Light

By Cheryl Clark

From Health Leaders Media, 2.13.2014

Hospitals are used to focusing on 30-day readmissions for heart failure, pneumonia and heart attack, but CMS is thinking much bigger these days. In addition to the COPD, total knee and total hip readmissions that will be tracked later this year, CMS is looking at post-surgical complications resulting in a readmission. Many providers and hospitals are focused on inpatient complications from surgery and pay less attention to the complications that may arise after the patient has gone home to recover. While there is no official word about when this could be adopted, readmissions penalties may soon include those due to surgical complications.

RESOURCES
The Talking Touchscreen® and Health Literacy

The Talking Touchscreen®, a multimedia health information technology tool, was developed as a user-friendly way of assessing patient-reported outcomes and as a tool to help end health disparities in underserved populations. The CancerHelp Talking Touchscreen® and DiabetesHelp Talking Touchscreen® have been integrated with the CancerHelp Institute's patient education programs. Patients now have access to information from AHRQ, the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases on treatment, support, side effects and screening.  

SAFER Guides for EHRS
A new set of guides and interactive tools designed to help health care providers use electronic health records (EHRs) more safely has been released by the Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC). The SAFER Guides are a suite of tools that include checklists and recommended practices to help health care providers assess and optimize the safety and safe use of EHRs.

HealthIT.gov 

Science of Improvement Whiteboard Series
Sometimes the language of improvement, whether it's theories such as Deming's Profound Knowledge or tools such as driver diagrams and PDSAs, can be a bit intimidating. It doesn't have to be. IHI Executive Director of Performance Improvement, Bob Lloyd, PhD, has been teaching the science of improvement all over the world for more than 20 years. The IHI Open School has compiled a series of short "whiteboard" videos in which Lloyd breaks down the core concepts of improvement science. 
Healthy Transitions Webinars Available 

Recordings and slides of our monthly webinars are located on the Education page of the Healthy Transitions Colorado Website. 

Healthy Transitions Colorado Education Page 

In This Issue
Upcoming Events
Webinar: Care Transitions and Health Exchanges
Call to action 
MEDICATION RECONCILIATION
WORK GROUP

HTC is putting together a group to begin work examining medication reconciliation efforts across Colorado. Medication reconciliation  is a critical piece of successful care transitions and we would like to expand the available resources on what is happening in Colorado. This group will be led by Donna Kasuda from Think About It Colorado. Please click here if you are interested in joining this group!


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Healthy Transitions Colorado is a collaborative effort, focused on aligning and accelerating existing efforts to improve transitions of care for Coloradans. Our guiding principles are simple - by working together to break down the silos of health care, we can foster true community care coordination across facilities, specialties, and practices. 
 

 

 

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