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CMS Selects The Lewin Group for Project to Reduce Hospital Readmissions, Improve Outcomes for Medicare Patients

June 28, 2011

  • Consulting firm to provide guidance, strategic assistance for more than 500 hospitals, community-based organizations involved in care transition program
  • Initiative expected to improve experience of Medicare patients who, without transition plan, face significant risk of adverse health event within three weeks of hospital discharge

FALLS CHURCH, Va.--(June 28, 2011)--The Centers for Medicare & Medicaid Services (CMS) has selected The Lewin Group to help reduce the number of hospital readmissions for Medicare beneficiaries, and improve quality and outcomes when patients transition from hospitals to other settings, such as their homes or long-term care facilities.

CMS awarded The Lewin Group, an OptumInsight company, $2.3 million for the first year of a 5-year program to assist hospitals and community-based organizations participating in the Community-based Care Transitions Program (CCTP). The program’s goals include: improving the transition of Medicare beneficiaries from inpatient hospitals to home or other care settings; improving the quality of care; reducing hospital readmissions for high-risk beneficiaries; and achieving measurable savings for the Medicare program, the nation’s federally-funded health insurance program for Americans 65 and older.

The Medicare Payment Advisory Commission (MedPAC) estimates that the cost to Medicare for readmissions to hospitals is about $15 billion, of which as much as $12 billion is thought to be preventable through improved care. The federal Partnership for Patients, a new public-private initiative, will provide funding for care transition services delivered to high risk Medicare beneficiaries, a service that is not currently reimbursable under the Medicare program. Successful care transitions are expected to save the Medicare program billions of dollars over the next several years.

The CCTP provides funding to test models for improving care transitions for high-risk Medicare beneficiaries as part of the Partnership for Patients initiative, whose goal is to reduce readmissions to hospitals by 20 percent by 2013. This would mean preventing approximately 1.6 million readmissions that CMS estimates are avoidable.

The Lewin Group and its team will provide technical assistance and guidance for an estimated 500 community based organizations (CBOs) and hospitals expected to be involved in the project. Lewin will gather best practices through site visits and facilitate peer to peer information sharing through online collaboration and national meetings. The Lewin Group’s team includes the Colorado Foundation for Medical Care, the University of Colorado, Seamon Corporation, 371 Productions and ON24.

“Readmissions are a particular challenge for patients with multiple chronic conditions. Community-based organizations are well-placed to facilitate seamless transitions among hospitals, providers, caregivers and with patients themselves to improve health outcomes,” said Lisa Alecxih, senior vice president and project lead, The Lewin Group.

“The Lewin Group and CMS believe that improving care transitions and reducing hospital admissions will help improve patient care and reduce costs for care providers,” said Lisa Chimento, CEO of The Lewin Group. “We are grateful for the opportunity to leverage our experience with other CMS efforts and relationships with community-based organizations across the country in this endeavor.”

About The Lewin Group
The Lewin Group is a premier national health care and human services consulting firm with more than 40 years’ experience finding answers and solving problems for leading organizations in the public, nonprofit, and private sectors. With its industry experience and knowledge, The Lewin Group provides its clients with high-quality products and insightful support to help them maximize the delivery of programs and services that make a difference in the lives of their constituents. For more information on The Lewin Group, visit www.lewin.com.

The Lewin Group is a division of OptumInsight (formerly Ingenix), a part of Optum. OptumInsight is a leading provider of health information, technology and consulting services. Visit www.ingenix.com for more information. The Lewin Group operates with editorial independence and provides its clients with the very best expert and impartial health care and human services policy research and consulting services.

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