The Obama Administration coined the Partnership for Patients Program (PPP) in early 2011. Aim – bring in qualitative changes in healthcare for all Americans by providing better care at lower costs and introduce a new order in public-private partnership in managing healthcare. Centers for Medicare & Medicaid Services (CMS) has already set the standards for rewarding Accountable Care Organizations (ACO) for providing beneficiaries with better health outcomes.

Background

According to estimates, one in five Medicare patients discharged from hospitals is re-admitted within 30 days because of an ‘adverse event’ (injury resulting from medical management within three weeks of discharge). Also, one in seven Medicare beneficiaries gets injured on an average in the course of their care costing the government an estimated $4.4 billion annually. The impact of this is on 2.6 million seniors costing the government over $26 billion every year. This results in higher healthcare costs and lower patient satisfaction.

Partnership through Network Hospitals

Coordinated care can help prevent complications rising from hospital acquired conditions among patients. However, active involvement of patients and their family is important for an effective care program. Patients are also required to be given early treatment for chronic conditions to prevent medical complications. Keeping this in view the CMS innovation Center has taken the new initiative of sponsoring a Pioneer ACO Model. The target is to bring down the hospital acquired conditions by 40 percent by the end of 2013 compared to the figures of 2010.  USD218 million has already been awarded to 26 Hospital Engagement Networks that will identify solutions already in use to reduce healthcare acquired conditions and latter spread it to others. These network hospitals will work to develop learning collateral for other hospitals and provide a wide range of initiatives to improve patient safety, conduct intensive training programs, provide technical assistance to other hospitals, and establish methods to monitor quality improvement at different levels. CMS expects that with support of the new resources, hospitals will be able to bring down the number of preventable injury cases and medical complications to a great extent.

Role of Community-based Organizations

Community-based care transition program (CCTP) is a major component of PPP. Many times, patients with serious illness run the risk of error in setting of care when in transit. Occurrence of an ‘adverse event’ after discharge from the hospital has serious consequences. CMS has recently announced a community-based care transition program for high-risk Medicare patients to reduce hospital re-admissions where community-based organizations effectively take up this task using transition services. USD 500 million has also been allocated to community-based organizations up to 2015 for their active participation in the transition program by joining acute-care hospitals.

Stakes are high. According to the CMS Innovation Center, apart from addressing several issues of patients in hospitals this program has the potential to save up to $35 billion across the healthcare system. PPP is an innovative tool available to hospitals and healthcare service providers for improving patient care. However, safe, effective, and efficient care transitions require thoughtful collaboration among healthcare providers, hospitals, patient care providers and social service organizations.