North Carolina Cuts Hospital Readmissions by 20%

September 2013, Vol 4, No 7 - Value Propositions


Hospital readmissions for chronic diseases, including cancer, are associated with a significant and often preventable financial burden in the United States. In 2008, North Carolina instituted a statewide transitional care model to prevent repeated hospitalizations in high-risk patients with Medicaid insurance who have multiple chronic conditions. The transitional care model comprises comprehensive medication management, self-management education sessions for patients and families, and outpatient follow-up with a medical home that is informed of the hospitalization. In a study investigating the merits of the model between 2010 and 2011, the rate of repeated hospitalizations was 20% lower for patients receiving transitional care than for patients not receiving such care. The authors suggest that “locally embedded, targeted care coordination interventions can effectively reduce hospitalizations for high-risk populations.” Health Aff (Millwood). 2013;32:1407-1415