In The Spotlight

Hospital Readmissions: A Toolkit

Beginning on Oct. 1, 2012, hospitals for the first time faced a financial penalty for readmitting a Medicare patient whom they had already cared for in the past month. Data shows that readmissions have already fallen, although the policy remains controversial.

The Toolkit includes:

• An explanation of the penalties included in the ACA
• Key facts about hospital readmission rates and costs
• Links to news articles and reports explaining and analyzing the issue
• A list of health care experts who understand the issue and its implications

This new Toolkit can be found under the "Resources" tab above or by clicking here.

Over nine million Americans receive benefits from both Medicare and Medicaid costing over $315 billion in health care services in the two programs combined. The dual eligibles account for 15 percent of the Medicaid population and almost 40 percent of all Medicaid expenditures for medical services; and 20 percent of the enrollees in Medicare, but 30 percent of the expenditures. Who are the dual eligibles? How does the Patient Protection and Affordable Care Act (ACA) address cost and quality of health care issues for this population? What is the office of duals? What federal initiatives are helping to improve quality, integrate care and align financing? How are the states involved in serving dual eligibles? In improving their care and coping with the high cost of care? What do the demos hope to show? Read More

The patient-centered medical home (PCMH), also referred to as the primary care medical home, is a model that aims to transform the organization and delivery of primary care. Why are we investing in testing the patient-centered medical home model? What does current evidence say about the impact of PCMH models? Can these models generate savings for the health care system down the road? Do primary care practices have the capacity and time to develop these models? What resources are necessary to ensure a functioning PCMH? What is the status of the demonstration projects run under CMMI? What are some successes and challenges that active PCMHs have encountered? How else does the ACA provide support for patient-centered medical homes? A distinguished panel of experts addressed these and related questions.  Read More

States and the federal government must be ready to begin enrolling millions of people in insurance marketplaces in October of this year. By January 1, most Americans will have to have health coverage or pay a penalty. Most states are also expected to draw new federal money to significantly expand their Medicaid programs. Insurers, meanwhile, face new rules, and doctors, hospitals and other medical providers will experiment with payment models intended to encourage quality instead of volume when it comes to care. This briefing will be especially helpful to congressional staff members and others with limited knowledge of the Patient Protection and Affordable Care Act (ACA), but it will also be a useful review for anyone dealing with the complex issues leading up to major changes scheduled to take effect in 2014.  Read More