Providigm Research for Medicare Payment Advisory Commission (MedPAC) Cited in New England Journal of Medicine

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Article Stresses Importance of Hospital and Physician Partnerships with Skilled Nursing Facilities to Manage Medicare Costs, Maximize Savings and Care.

Dr. Kramer, CEO at Providigm

Dr. Andrew Kramer, CEO at Providigm

This commentary demonstrates that SNF readmission rates that our Research Team has been measuring for MedPAC since 2004, are now on the radar.

Entitled "Post-Acute Care -The Next Frontier for Controlling Medicare Spending", and published in the February 20, 2014 issue of New England Journal of Medicine, the Perspective commentary focuses on the importance of skilled nursing facilities (SNFs) in hospitals’ effort to maximize Medicare related savings and manage readmission penalties. The article, authored by Robert Mechanic, M.B.A., asserts that for hospitals and physicians: “Partnerships with SNFs are particularly important, since [SNFs] account for about half of Medicare spending.”

Providing several examples where hospitals and physicians may maximize savings and incentives while improving the quality of their patients’ care, Mechanic explains the importance in selecting and managing post-acute care options. Hospitals may analyze nursing home performance against other homes, he suggests, by comparing their risk-adjusted rehospitalization rates; rates that take into account the complex needs of the patients cared for within the nursing home. Hospitals may favor homes with lower risk-adjusted rates, a measure of both quality and efficiency, when choosing post-acute partnerships.

Citing Providigm’s 2013 report of variation in risk-adjusted readmission rates, based on analysis conducted for MedPAC, Mechanic illustrates the range of nationally reported rehospitalization rates. Rates were measured for five potentially avoidable conditions that often result in readmission: respiratory infections, heart failure, electrolyte imbalance, urinary tract infections, and sepsis.

“The Journal article offers a compelling look at the importance of post-acute care, particularly SNFs, in addressing the cost and quality challenges faced in health care for elders,” states Dr. Kramer, CEO of Providigm. “This commentary demonstrates that SNF readmission rates that our Research Team has been measuring for MedPAC since 2004, are now on the radar.”­­

Providigm's Research Team is the industry leader in analysis of national data on quality of SNF care and national rates of readmission to hospital from SNF. Led by Dr. Andrew Kramer, the team annually produces methodology to calculate risk-adjusted rates of readmission that are reported by MedPAC to Congress. MedPAC will release their 2014 Report that includes Providigm’s latest research on SNF quality and national risk-adjusted readmission rates in mid-March.

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