[Congressional Record (Bound Edition), Volume 158 (2012), Part 10]
[Extensions of Remarks]
[Page 14284]
[From the U.S. Government Publishing Office, www.gpo.gov]




           INTRODUCING MEDICARE TRANSITIONAL CARE ACT OF 2012

                                 ______
                                 

                          HON. EARL BLUMENAUER

                               of oregon

                    in the house of representatives

                       Friday, September 14, 2012

  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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