Blue Review
A newsletter for contracting institutional and professional providers

July 2018

Readmission Rates Discussed at Blue UniversitySM Event; Second Event Announced for This Fall

On June 13, 2018, BCBSIL, along with national and local thought leaders, gathered at the inaugural Blue University event to discuss reducing readmission rates. The keynote speaker, Suzanne E. Mitchell, M.D., M.S., a board-certified palliative care and family physician, health service researcher, medical educator and consultant in cross-cultural medical care and communication, shared her experiences and proven results to reduce readmission rates.

Dr. Mitchell highlighted three areas:

  • Best practices, strategies and tools to improve transitions of care
  • Problems during transitions of care and identified specific ways to start making improvements
  • Successful examples of transitions of care with several model programs

She discussed tools such as:

  • The LACE Tool which stands for Length of stay (<1 to ≥14 days), Acute admission, Comorbidities and Emergency department visits (in past 6 months). The LACE Tool helps identify high-risk patients who may need additional care.
  • Medication Therapy Management (MTM), which emphasizes medication safety and optimizing patient care and outcomes.
  • The Teach-Back method, a communication technique to help improve patient understanding.

In addition, Dr. Mitchell touched on Project RED – reducing readmissions through the Re-Engineered Discharge – a research group at Boston University Medical Center that develops and tests strategies to improve the hospital discharge process in a way that promotes patient safety and reduces re-hospitalization rates.1

Dr. Mitchell shared a statement from a patient that she felt summed up an important transition of care issue: “I need to know someone’s responsible for my care. That someone cares that I become healthy again.” She stressed the importance of listening and communicating effectively.

Also at the event, David Wenzel, senior director of Behavioral Health clinical operations for BCBSIL, and Tom Allen, medical director of Behavioral Health for BCBSIL, discussed the BCBSIL Behavioral Health Care Coordination and Early Intervention Program (CCEI®). The CCEI program includes a skilled team of CCEI clinicians that reach out to each member before, during and after a hospital admission, offering education and support as needed.

The over 150 physicians, clinicians and other external medical staff attending the Blue University event had the opportunity to ask the speakers transition of care questions and receive feedback on topics such as transportation issues, keeping appointments, medication discrepancies, home visits and resistance to treatment.

A panel discussion with Kris Alden, M.D., Hinsdale Orthopedics, Christopher Boyle, M.D., medical director, NorthShore Medical Group and Phil Branshaw, M.D., Fox Valley Medicine shared methods they’ve tried at their health care facilities, what they’ve learned from their experiences and best practices they are currently using. Although they admit there is no silver bullet, they emphasized identifying gaps, coordinating efforts and continuously communicating. Dr. Alden also reminded the group not to forget about the intake process in addition to transition of care.

John Franco, medical director at Century PHO in Chicago, said he enjoyed the event and he found the topic very relevant. “The speakers did a good job stressing the complexity of readmission rates but I was able to pinpoint some areas I would like to bring up with our Board.”

Barbara Loeb, chief medical officer of Chicago Health System, noted Dr. Mitchell’s emphasis that the tools presented at the Blue University event are meant to be taken back and modified so they are effective at her workplace. “It would be great to have a webinar for our case management staff to share all this data and tools,” she added.

“It really helped me to think outside the box,” said Chris McGeever, manager of complex case management at Chicago Health System. “It is so easy to get stuck in our everyday routine. It’s nice to know they’re experiencing the same thing.”

Tony Vancauwelaert, M.D., FAAFP, medical director for BCBSIL, wrapped up the event by reminding the audience that providers – including support staff – payers and patients are all in this together. “We’re all wanting to do this together to improve the health of our patients, community and country.”

BCBSIL Executive Director of Network Performance Geoff Guiton announced the second Blue University event will be held this fall with a focus on Behavioral Health. Opportunities to receive Continuing Medical Education (CME) credits will be available.

1Project RED, Re-Engineered Discharge, 2014, https://www.bu.edu/fammed/projectred/