DataPoint: Avoidable Hospitalizations

The New York–Reducing Avoidable Hospitalizations (NY–RAH) initiative saw a 9 percent reduction in the overall probability of nursing home residents having an all-cause hospitalization in 2015 compared to 2012 hospital utilization. The NY–RAH program is a NYC pilot program with 29 participating facilities. Outcomes of the study suggest seven out of eight utilization estimates with fewer hospitalizations. Medicare expenditures showed mixed results in the Centers for Medicare and Medicaid Services' (CMS) February 2017 report, Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents: Annual Report Project Year 4. Total estimated Medicare expenditures and physician services expenditures saw small increases during the four-year evaluation period, while all other measures of expenditures had estimated decreases. The mixed Medicare expenditure results suggest that the hospitalizations prevented by the Enhanced Care and Coordination Providers (ECCP) intervention may be exclusive to lower-cost initiatives, while more expensive hospitalizations remain burdensome.

The ECCP’s education-based program is intended to assist facilities in both identifying causes of potential avoidable hospitalizations and reviewing and modifying its procedures to prevent avoidable hospitalizations. The entire CMS report is available here.

Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820