Hospitals that participated in the Southeast Michigan “See You in 7 Collaborative” experienced substantial reductions in 30-day readmission rates and Medicare payments related to heart failure (HF) care.
Increases in postdischarge 7-day follow-up were modest “but associated processes aimed at this goal may have improved the overall transition from inpatient to outpatient care,” Dr. Scott L. Hummel reported online Sept. 9 in JACC: Heart Failure. “Our study suggests that regional hospital collaboration to share best practices can be an effective strategy to reduce HF readmissions and associated costs.”
American Heart Association
Established in 2011, the Southeast Michigan See You in 7 Collaborative is an effort by the Greater Detroit Area Council, the American College of Cardiology’s Michigan Chapter, the Michigan Peer Review Organization, and 11 previously nonaffiliated hospitals to increase 7-day postdischarge follow-up and reduce all-cause 30-day readmission rates in HF patients. Over a 1-year period, Dr. Hummel, a cardiologist at the University of Michigan, Ann Arbor, and his associates examined the rates of 7-day follow-up and 30-day readmissions in Medicare fee-for-service HF patients among the 10 collaborating hospitals, and compared the findings to trends in the state’s 82 nonparticipating hospitals. The preintervention period studied was May 2011-April 2012; the intervention occurred from May 2012-April 2013.
During the intervention period, the rates of 7-day postdischarge follow-up increased significantly but remained low in both groups (from 31.1% to 34.4% in collaborating hospitals, and from 30.2% to 32.6% in nonparticipating hospitals). At the same time, the rates of unadjusted readmissions significantly decreased in both groups (from 29% to 27.3% in collaborating hospitals and from 26.4% to 25.8% in nonparticipating hospitals). The researchers also found that the mean risk-standardized 30-day, all-cause readmission rates improved significantly among collaborating hospitals (from 31.1% to 28.5%), but significantly less so among nonparticipating hospitals (from 26.7% to 26.1%).
Finally, combined Medicare payments for inpatient and 30 days of postdischarge care decreased by an average of $182 per beneficiary in collaborating hospitals and by $63 in nonparticipating hospitals (JACC Heart Fail. 2015 Sept 9; [doi:10.1016/j.jchf.2015.06.007]).
The researchers acknowledged certain limitations of the study, including its observational design and the fact that administrative data sets were used to determine the outcomes of interest. “Given the observational nature of the study, we cannot confirm that improvements in 7-day follow-up or 30-day readmission rates directly resulted from See You in 7 Collaborative participation,” they noted.
The study was funded in part by the Robert Wood Johnson Foundation. Dr. Hummel disclosed that he is supported by a grant from the National Heart, Lung, and Blood Institute. The remaining study authors reported having no financial disclosures.