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Markey, Kerry, Capuano: Massachusetts Wins $11.6 Mil, More Expected for Innovative Health Care Reforms

Press Release

Location: Boston, MA

Senator John Kerry, along with Congressmen Edward Markey and Michael Capuano, today announced that Massachusetts will receive over $11.6 million in the first round of Health Care Innovation Awards from the U.S. Department of Health and Human Services to support innovative projects that aim to save money, deliver high quality medical care, and enhance the overall health care workforce. The awards are part of $1 billion in upcoming grants from the Center for Medicare and Medicaid Services (CMS) Innovation Center, created by the Affordable Care Act and championed in the Finance Committee by Senator Kerry.

Today's funding will go toward new projects that include collaborations of leading hospitals, doctors, nurses, pharmacists, technology innovators, community-based organizations, and patient advocacy groups, among others, located in urban and rural areas that will begin work this year to address health care issues in local communities.

"Once again, Massachusetts will serve as the national epicenter for innovative approaches to health care that can improve the delivery of care while lowering costs," said Rep. Markey. "We will be working to prevent patients from falling through the cracks when they are moved from the hospital to their home or a nursing facility, which currently costs Massachusetts an estimated $900 million per year. We are going to do a better job preventing asthma attacks in children and improving care for the homeless, avoiding thousands of preventable trips to the emergency room. While Republicans propose slashing health care spending to avert cuts to the defense budget, these new initiatives show that we can save money without slashing health care services for children, seniors, and middle-class families."

"This investment is one of the dividends of leading the nation in health care reform. This first round of Health Care Innovation Awards will help us stay ahead of the curve," said Sen. Kerry. "In real terms this puts more money back in the pockets of families across the state who depend on Medicare, Medicaid, and CHIP, without sacrificing quality medical care."

"These grants address significant problems in public health: unnecessary hospital readmissions of Medicaid-Medicare dual eligibles, childhood asthma, and healthcare for homeless persons," said Rep. Capuano. "Academic and community medicine work hand in hand to advance medical knowledge and to increase access to care and I am pleased that these initiatives are receiving funds."

The CMS Innovation Center fosters health care transformation by finding new ways to pay for and deliver care that improve care and health while lowering costs. The Center identifies, develops, supports, and evaluates innovative models of payment and care service delivery for Medicare, Medicaid and CHIP beneficiaries using an open, transparent, and competitive process. Established by the Affordable Care Act, the Center for Innovation is a new engine for revitalizing and sustaining Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) and ultimately for improving the health care system for all Americans.

As a senior member of the Senate Finance Committee, Kerry filed an amendment that was included in the Affordable Care Act which expanded the focus of the CMS Innovation Center, allowing the Medicaid and CHIP programs to participate in important health care delivery reforms.

The following projects have received funding:

Beth Israel Deaconess
Project Title: "Preventing avoidable re-hospitalizations: Post-Acute Care Transition Program (PACT)"
Geographic Reach: Massachusetts
Funding Amount: $4,937,191
Estimated 3-Year Savings: $12.9 million
Summary: Beth Israel Deaconess Medical Center of Boston, Massachusetts, is receiving an award to improve care and reduce hospital readmissions for over Medicare and beneficiaries dually eligible for Medicare and Medicaid who represent over 8000 discharges for conditions such as congestive heart failure, acute myocardial infarctions, and pneumonia. By integrating care, improving patients' transitions between locations of care, and focusing on a battery of evidence-based best practices, this model is expected to prevent complications and reduce preventable readmissions, resulting in better quality health care at lower cost in the urban Boston area with estimated savings of almost $13 million over 3 years. Over the three-year period, Beth Israel's program will train an estimated 11 health care workers, while creating an estimated 11 new jobs. These workers will include care transition specialists who will help integrate care between hospital and primary care practices.

Health Resources in Action
Project Title: "New England asthma innovations collaborative"
Geographic Reach: Massachusetts, Rhode Island, Connecticut, Vermont
Funding Amount: $4,040,657
Estimated 3-Year Savings: $4.1 million
Summary: Health Resources in Action is receiving an award for a program of its New England Asthma Regional Council, titled the New England Asthma Innovations Collaborative (NEAIC). NEIAC is a multi-state, multi-sector partnership that includes health care providers, payers, and policy makers aimed at creating an innovative Asthma Marketplace in New England that will increase the supply and demand for high-quality, cost-effective health care services. Over the three year funding period, services will be delivered to over 1400 children ages 2-17 with persistent asthma who have had at least one related emergency department visit, observation stay, hospitalization or received a prescription in the 12 months prior to enrollment. The intervention will lower costs of asthma care by delivering cost-effective prevention oriented care in clinics and at home to reduce preventable pediatric-related emergency department visits and hospital admissions with estimated savings of over $4 million. NEAIC will also train an estimated 64 health care workers, while creating an estimated 17 new jobs. These workers will include well-trained community health workers and asthma educators. Finally, NEAIC will work to sustain these cost-effective services by piloting reimbursement methodologies with payers. In sum, NEAIC will create a new type of workforce and service delivery model that targets cost-effective and culturally competent care, which features patient self-management education, environmental interventions and long-term sustainability payment mechanisms of these services.

The National Health Care for the Homeless Council
Project Title: "Community health workers and HCH: a partnership to promote primary care"
Geographic Reach: New Hampshire, Texas, Nebraska, Massachusetts, Illinois, Florida, North Carolina, California
Funding Amount: $2,681,877
Estimated 3-Year Savings: $1.5 million
Summary: The National Health Care for the Homeless Council is joining into a cooperative agreement to serve ten communities across various regions in the U.S. to reduce the number of emergency department visits and lack of primacy care services for over 1700 homeless individuals. The intervention will integrate community health workers into Federally Qualified Health Centers to conduct outreach and case coordination for transitioning this population from the emergency department to a health center, thus reducing unnecessary emergency department visits and improving quality of care for this population with estimated savings of approximately $1.4 million. Over the three-year period, National Health Care for the Homeless Council's program will train an estimated 101 health care workers, while creating an estimated 17 new jobs. The workers will include community health workers who will conduct outreach and care coordination.

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