Dive Brief:
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Preventable hospitalizations for long-term care facility patients with certain conditions and eligible for both Medicare and Medicaid have declined by 31% between 2010 and 2015, according to CMS.
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Avoidable hospitalizations for dually-eligible patients in long-term care dropped from 227 per 1,000 beneficiaries in 2010 to 157 per 1,000 beneficiaries in 2015, the agency stated in a blog post.
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The overall hospitalization rate among dually eligible patients has declined by 13% in recent years.
Dive Insight:
The ACA, the first item on the new administration's chopping block, has helped to drive the reduction in preventable hospitalizations with major provisions that address prevention. Other initiatives, which include the Hospital Readmission Reduction Program, bundled payments, and efforts to support accountable care organizations, have also helped to reduce preventable hospitalizations.
In addition, the reduction could be partly attributed to value-based care initiatives that target largely preventable or manageable conditions, including bacterial pneumonia, urinary tract infections, congestive heart failure, dehydration, and chronic pulmonary disease, CMS suggested.
The reductions in hospitalizations among dual-eligible patients provides a snapshot of the government's recent progress. Yet there is still room for improvement. The more than 270,000 Medicare beneficiaries eligible for Medicaid benefits hospitalized in 2015 indicates an area where the government could look for potential savings.
