What is the PSO's Role in Helping Hospitals Reduce Unnecessary Readmissions?
The Affordable Care Act (ACA) designates PSOs to help hospitals with high readmission rates improve their performance. The ACA also calls for the Department of Health and Human Services (HHS) to make available a program to support PSOs in this work. As part of this program, the information presented here is designed for PSOs that wish to assist hospitals in reducing unnecessary readmissions. For more details go to: http://www.pso.ahrq.gov/readmin/psoaca.htm. To find a PSO, go to: http://www.pso.ahrq.gov/listing/psolist.htm
What Hospitals are “Eligible” to Work With a PSO on Readmissions?
The Centers for Medicare & Medicaid Services (CMS) prepares a list of hospitals with high readmission rates as part of its Community-based Care Transitions Program. To view the list of hospitals with high readmission rates, go to: http://www.cms.gov/DemoProjectsEvalRpts/downloads/CCTP_FourthQuartileHospsbyState.pdf, (PDF Help). Hospitals not on this list also may work with PSOs to reduce unnecessary readmissions.
Resources on Reducing Unnecessary Hospital Readmissions
There are many resources and tools that can be used to improve the readmission process. The following link provides a list of resources: http://www.pso.ahrq.gov/readmin/readminres.htm
Community-based Efforts to Reduce Unnecessary Readmissions
Partnership for Patients, a national public–private initiative, has set a goal of reducing unnecessary hospital readmissions by 20% by 2013 (from 2010 baseline data). The Community-based Care Transitions Program, authorized under Section 3026 of the ACA, will contribute to achieving this goal. For more details go to: https://www.cms.gov/demoprojectsevalrpts/md/itemdetail.asp?itemid=CMS1239313 (solicitation) on the CMS' site, Section 3026 of the ACA, or the Center for Medicare & Medicaid Innovation’s (CMMI) site once projects come online. The ACA also allows individual hospitals to work with PSOs on reducing high readmission rates by improving the transition process for a patient being discharged from hospital to home.
In addition, Quality Improvement Organizations (QIO), State-based organizations that work under contract to CMS to improve care for Medicare beneficiaries, are helping selected communities in their States collaborate on efforts to reduce unnecessary hospital readmissions. To learn more about this QIO work, go to: http://www.cfmc.org/integratingcare/about.htm.
Help Patients Get Better Care
Asking questions about a medical condition, diagnosis, or hospital visit can prepare patients to take care of themselves at home and reduce the likelihood of a return trip to the hospital. AHRQ and the Ad Council developed “Questions Are the Answer,” a multimedia campaign on the importance of asking questions about health. For patient stories, resources and tools, go to: http://www.ahrq.gov/questions/. AHRQ also offers a number of health education materials to help patients get better care. For more details, go to: http://www.ahrq.gov/patients-consumers/.
If you have questions about ACA provisions that apply to PSOs, or how your PSO can help a hospital improve a high readmission rate, contact the PSO Office at: PSO@ahrq.hhs.gov.
Current as of March 2013
Reducing Unnecessary Hospital Readmissions: The Role of the Patient Safety Organization (PSO). Agency for Healthcare Research and Quality, Rockville, MD. http://www.pso.ahrq.gov/readmin/readmin.htm