Dr. Audrey Paulman plays key role
A UNMC physician, Audrey Paulman, M.D., family medicine, was involved recently in a statewide effort aimed at lowering costs for Medicare patients by reducing hospitalizations and rehospitalizations.
Dr. Paulman serves as principal clinical coordinator for CIMRO of Nebraska, the Medicare Quality Improvement Organization (QIO) for the state of Nebraska. CIMRO works with health care organizations to assure that services delivered are appropriate, safe and high quality and that consumers are educated about their rights and what can be done to ensure they receive the right care, at the right time, every time.
In her position with CIMRO, Dr. Paulman was involved in a study that appeared in the Jan. 23 issue of the Journal of the American Medical Association. The study determined that hospitalizations and rehospitalizations among Medicare patients declined nearly twice as much in communities where QIOs coordinated interventions with communities.
The study showed how state‐based QIOs, funded by the Medicare program, systematically coordinated community‐based efforts to improve the quality of care transitions and avoid costly readmissions.
CIMRO of Nebraska is one of the 14 state‐based QIOs that received funding from the Centers for Medicare & Medicaid Services (CMS) to participate in the project.
Readmitting Medicare patients to the hospital within a month of discharge is a frequent and costly occurrence. The study results show that interventions aimed at improving care transitions – when patients move from one care setting to another, such as from a hospital to their home – reduced rehospitalizations for Medicare patients by almost six percent in 14 select communities nationwide, including in Omaha.
Almost 25 percent of heart failure patients on Medicare are readmitted to the hospital within 30 days of discharge. The federal government says avoidable hospital readmissions cost the Medicare program billions of dollars a year.