Care-tran­si­tions pro­gram de­serves more time for eval­u­a­tion

Modern Healthcare - - COMMENT -

Thank you for the ex­cel­lent ar­ti­cle on the Com­mu­nity-based Care Tran­si­tions Pro­gram (“Care-tran­si­tion fum­bles high­light CMS’ re­form chal­lenges,” ModernHealth­, April 28). While not ev­ery in­no­va­tion tested by the CMS is go­ing to work, the eval­u­a­tion should al­ways be fair and give us in­sights into how to im­prove in the fu­ture. At the John A. Hart­ford Foun­da­tion, we have in­vested our phil­an­thropic dol­lars in re­duc­ing read­mis­sions be­cause of the suf­fer­ing they rep­re­sent as well as the waste. We are very proud of Eric Cole­man’s Care Tran­si­tion In­ter­ven­tion, on which the CCTP pro­gram is largely based.

The CCTP, en­acted as part of the Af­ford­able Care Act, seems to suf­fer from “not be­ing in­vented here” from the CMS’ per­spec­tive. As those in­ter­viewed ob­served, the eval­u­a­tion by Econo­met­rica is pre­ma­ture. Some sites had only a few months’ worth of cases en­tered into the anal­y­sis. Worse, com­pared with other early eval­u­a­tions of pro­grams such as bun­dled pay­ments or com­pre­hen­sive pri­mary care, there was very lit­tle con­text or in­for­ma­tion from the or­ga­ni­za­tions di­rectly in­volved, much less the cru­cial voices of pa­tients and their fam­i­lies, mak­ing it very hard to know how to im­prove.

The CMS’ choice to kick pro­grams out of CCTP for low rates of en­roll­ment is strange, since agen­cies re­ceive case rate pay­ments only for those ben­e­fi­cia­ries they ac­tu­ally serve. Al­low­ing sites more time to im­prove their re­la­tion­ships with hos­pi­tals and en­roll­ment pro­cesses costs noth­ing. Christo­pher Langston

Pro­gram direc­tor John A. Hart­ford Foun­da­tion

New York

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