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Introducing Medicare Transitional Care Act of 2012

Floor Speech

Location: Washington, DC

Mr. BLUMENAUER. Mr. Speaker, today, together with a group of bipartisan cosponsors, I am proud to introduce the Medicare transitional Care Act of 2012, legislation to aid patient transitions from one care setting to another within our health care system. The legislation will improve patient health outcomes, reduce hospital readmissions, and save valuable healthcare resources.

When people leave the hospital after an operation or illness, they are often overwhelmed by a complicated and risky road to recovery. Patients frequently report difficulty remembering clinical instructions, confusion over medications, and in cases where multiple providers are involved, can receive conflicting instructions from different providers.

A study published in April 2009 in the New England Journal of Medicine found that almost one third of Medicare beneficiaries studied who were discharged from a hospital were re-hospitalized within 90 days. Additionally, one-half of the individuals re-hospitalized had not visited a physician since their discharge, suggesting a lack of follow-up care. The study estimated that Medicare spent $17.4 billion in 2004 on unplanned re-hospitalizations.

In its June 2012 Report, Medicare Payment Advisory Commission, MedPAC, highlighted the need for an explicit payment for transitional care services, given the documented evidence that effective and coordinated care transitions improve health outcomes, reduce readmission rates, and generate significant savings to the U.S. health care system. The Congressional Budget Office has echoed these findings. In a report documenting lessons from Medicare's demonstration projects, the CBO emphasized that ``programs that smoothed transitions (for example, by providing additional education and support to patients moving from a hospital to a nursing facility or between a primary care provider and a specialist) tended to have fewer hospital admissions.''

There are some well-established and peer-reviewed programs that could be adopted. For example, the Transitions Care Model, which assigns a transitional care nurse during the transition period, has resulted in cost savings of approximately $5,000 per patient. Other models also have demonstrated savings, such as the Care Transitions Intervention model, which provides patients with a transitions coach and self-management tools, has reduced hospital readmission rates from 20 percent to 12.8 percent, while Project Better Outcomes for Older adults through Safe Transitions, BOOST, which provides hospitals with management tools and mentoring programs to improve the discharge transition process, resulted in lower rates of mortality and 30-day readmissions rates dropped from 25.5 percent to 8.5 percent for those under age 70.

It is our hope that stakeholders involved in the care delivery system will carefully evaluate this legislation and provide comments or suggested improvements to me and the other sponsors. We are interested in ensuring that the legislation's terms are adequately tailored to the different circumstances and settings in which these transitions occur.

Providing a transitional care benefit within Medicare will help coordinate care, develop a care plan for patients and their caregivers, identify potential health risks, and prevent unnecessary hospitalizations. I thank my cosponsors and look forward to working with my colleagues to advance this legislation.

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