A community hospital in Kentucky has found that employing lay outreach workers to assist patients recently discharged from the hospital can significantly reduce hospital readmissions.

In a research project, the hospital identified high-risk patients and, upon their discharge from the hospital, assigned lay outreach workers to help those patients with matters such as providing transportation, assisting during follow-up medical appointments, and navigating the health care system.  With this help, the hospital experienced a 48 percent reduction in 30-day readmissions.

While the hospital needed to spend money to employ the outreach workers, the effort reduced its likelihood of being assessed penalties for excessive readmissions under Medicare’s hospital readmissions reduction program.

Learn more about the project, its methodology, and its findings in the article “Reducing 30-day readmission rates in a high-risk population using a lay-health worker model in Appalachia Kentucky,” which can be found here in the journal Health Education Research.…

Faced with continued increases in the cost of prescription drugs in their Medicaid programs, states are pursuing new approaches in attempts to control those rising costs.

In the past states have employed approaches such as beneficiary prescription limits, negotiating supplemental rebates from manufacturers, requiring prior authorization, implementing state maximum allowable cost programs, and operating preferred drug lists.

Recently, however, states are turning to a number of new mechanisms to limit the growth of Medicaid prescription drug costs, including:

• introducing spending growth caps for Medicaid prescription drug costs, with unplanned increases in spending triggering a closer look at overall drug spending and a focus on specific drugs for utilization review;
• closed formularies;
• doing more to promote the use of generic drugs;
• limiting generic drug price increases;
• increasing prescription drug price transparency;
• enacting manufacturer transparency laws;
• adopting pharmacy benefit manager transparency laws;
• aligning prices to federally negotiated drug prices.

Learn more about how state Medicaid prescription drug spending has grown and the steps states are taking to control that growth in the Kaiser Family Foundation report “Snapshots of Recent State Initiatives in Medicaid Prescription Drug Cost Control,” which can be found here.…

Nearly half of the patients served by community health centers have housing problems, according to a new report published by the Journal of the American Medical Association.

Among those problems:  two or more homes in the past year alone, difficulty paying their rent or mortgage, and homelessness.  Some have homes that are not their own.

Practitioners need to understand this and help patients address their housing challenges, the study suggests, because housing concerns often prevent such patients from complying with medical instructions.

Learn more about how housing challenges affect health and health care in the JAMA report “Prevalence of Housing Problems Among Community Health Center Patients,” which can be found

Nearly half of the patients served by community health centers have housing problems, according to a new report published by the Journal of the American Medical Association.

Among those problems:  two or more homes in the past year alone, difficulty paying their rent or mortgage, and homelessness.  Some have homes that are not their own.

Practitioners need to understand this and help patients address their housing challenges, the study suggests, because housing concerns often prevent such patients from complying with medical instructions.

Learn more about how housing challenges …

Medicare’s chronic care management program appears to be reducing the cost of caring for participants while improving their quality of life.

The program, which pays physicians for non-face-to-face services they provided to coordinate care for their Medicare patients with at least two chronic medical conditions, was introduced in 2015.  An analysis of its performance found that payments of up to $50 a month

…improved patient satisfaction and adherence to recommended therapies, improved clinician efficiency, and decreased hospitalizations and emergency department (ED) visits.

While Medicare paid roughly $52 million in chronic care management fees during the initial program period, the program produced a net savings of $36 million, mostly because patients needed less inpatient and outpatient care.

Learn more about Medicare’s chronic care management program and its initial impact on patient health and Medicare costs in the report Evaluation of the Diffusion and Impact of the Chronic Care Management Services:  Final Report, which can be found here.…

The federal government needs to do a better job of evaluating Medicaid demonstration programs, according to the U.S. Government Accountability Office.

Demonstration programs, on which the federal government spends more than $300 billion a year, exempt states from selected federal Medicaid requirements and regulations so they can test new approaches to providing and paying for care for their Medicaid population.  As part of waiving these requirements, the Centers for Medicare & Medicaid Services requires the states to perform or commission evaluations of the effectiveness of those new approaches.

According to a new GAO study, however, those reports are not always performed in a timely manner, are sometimes too limited in scope, and their results are not sufficiently publicized so that others may learn lessons from the demonstration.  The GAO recommended that CMS establish written procedures for such matter and CMS agreed with this recommendation.

Learn more about the GAO’s review of Medicaid demonstration program evaluations in the GAO report Medicaid Demonstrations:  Evaluations Yielded Limited Results, Underscoring Need for Changes to Federal Policies and Procedures, which can be found here.…