University leads mentoring program to reduce hospital re-admissions

BY DEVON THORSBY
Daily News Editor
Published May 16, 2010

Signed into law by President Barack Obama earlier this year, the Patient Protection and Affordable Care Act is the centerpiece of the administration’s agenda for health care reform. However, concerns over the potential financial burden imposed by the act’s provisions have led the legislation's critics to question its feasibility.

But a new mentoring program for physicians and hospitals could silence critics by lowering the cost of health care reform without compromising universal coverage to all American citizens.

Michigan Transitions of Care Collaborative — known as MTC² — is a system spearheaded by the University, Blue Cross Blue Shield of Michigan and the Society of Hospital Medicine that aims to improve the transition from in-patient to out-patient care, reducing patient re-admission to hospitals.

Comprised of 15 physicians’ organizations and 14 partnering hospitals, MTC² is based on a system created by the Society of Hospital Medicine, called Project Better Outcomes for Older Adults through Safer Transitions, which focuses on the education and development of medicine, specifically in a hospital setting.

Project BOOST, which aims to improve the care of elderly patients who move between hospitals and their homes, began its pilot mentoring program in fall 2008. Now implemented in hospitals nationwide, the program was initially designed to reduce hospital re-admission rates in the 30-day period after the initial release, improve communication between in-patient and out-patient facilities and increase patient satisfaction.

David Share, the executive medical director of Blue Cross Blue Shield of Michigan, said the collaboration between the three institutions is essential to the creation of a truly interconnected health care system for the state of Michigan.

“The reason we got involved was to bring people together, to convene them and set the stage,” Share said. “(We wanted) to help them work together and to find the best approach.”

Share said the Society of Hospital Medicine’s work through Project BOOST has worked to improve health care systems by prioritizing both patient health and reduced health care costs.

“The hope is that people will take the expertise that already exists and the BOOST project in particular to work together across hospitals to find the best way to discharge people from hospitals,” Share said.

According to Share, Blue Cross Blue Shield has partnered with the Society of Hospital Medicine fairly regularly since 1997 on various multi-collaborative projects, which were typically focused on physician practices. In a similar vein, MTC² is designed to create a better link between physicians’ practices and hospitals.

“There is a wide recognition that there are problems with hand-offs, with the hospital in-patient environment and the out-patient environment,” he said.

Unplanned re-admission to hospitals throughout the United States costs Medicare $17.4 billion each year, according to a May 13 Blue Cross Blue Shield press release. The cost estimates increase after consideration of patient re-admission not covered by Medicare.

Christopher Kim, program director for MTC² and clinical assistant professor of internal medicine at the University, said in a phone interview on Friday that the goal of the collaboration is to streamline the use of resources within the hospital to improve the health of patients before their release.

“When patients leave the hospital, it’s oftentimes considered a phase in which patients still may have ongoing needs,” he said. “They need to get back to their primary care provider in a safe and easy way.”

Kim said the work to organize the collaborative began in the fall last year, with calls to physicians’ organizations interested in participating in the program.

In March of this year, the collaborative selected specific physicians’ organizations and partnering hospitals from the applicant pool, focusing on their abilities to implement the program and represent different regions of Michigan, according to Kim.

Kim said the first training conference for the participating physicians’ organizations began this past Monday, consisting of two days of education seminars led by experts from the Society of Hospital Medicine.

“The goal of this collaborative is to learn together, to provide better, safer and more quality care throughout Michigan," said Kim.

Kim added that the next phase of MTC² will likely begin this winter or early next year.

“We certainly do hope that other organizations throughout the state will want to be part of this collaborative,” Kim said.

Share said if the program is properly implemented, it could not only make the health care system more efficient but also sufficient.

“People won’t fall through the cracks,” Share said. “They won’t get sick afterwards, they won’t miss follow-up appointments and they’ll overall be healthier after receiving the treatment they need.”

While other mentoring programs have been developed in the past to improve medical systems, Kim said MTC² is the first to apply to both physicians’ care and hospitals on a large scale.

“This is a very unique thing about the state of Michigan,” he said. “As far as we know, there are no other states that are doing this. We feel we can pave the way and show how this can be done in a successful way…throughout the country.”