Jul 072011

The July 2011 issue of Health Affairs features an article describing early achievements of the four-state, four-year STAAR initiative (State Action on Avoidable Rehospitalizations), which is underway in Washington, Michigan, Ohio, and Massachusetts. STAAR aims to mobilize state-level leadership to improve care transitions. According to “An Early Look at a Four-State Initiative to Reduce Avoidable Hospital Readmissions,” 148 hospitals are working with more than 500 cross-continuum team partners. For the abstract and information on obtaining the complete article, go to: http://content.healthaffairs.org/content/30/7/1272.abstract

The article notes that no data are yet publically available on the initiative’s success at reducing avoidable readmissions, but adds that “…the effort has so far been successful in aligning numerous complementary initiatives within a state, developing statewide rehospitalization data reports, and mobilizing a sizable number of hospitals to work on reducing rehospitalizations.” Although each state has issues specific to its systems, several cross-state issues have emerged. The authors describe the need for organizations to address systemic barriers, including:

• Obtaining the best available statewide data on rehospitalizations;

• Understanding the financial impact of reduced rehospitalizations on hospitals; and

• Aligning incentives to improve transitions.


Based on early results and insights, the authors make several recommendations to policymakers, including:

• Design programs that go beyond “the walls of the hospital,” as hospitals will not “be able to reduce these rates sustainably without the explicit partnership of community-based providers.”

• Consider forming a state-level, multistakeholder organization that can “ignite action, generate momentum, and leverage networks to increase interest in and visibility of a common aim.”

• Develop incentives and updated payment policies that are needed to support the costs of coordinated care across settings.

In related news, the Institute for Healthcare Improvement has just released its new how-to guide for hospitals working to improve cross-setting care transitions. How-To Guide: Improving Transitions from the Hospital to Post-Actue Care Settings to Reduce Avoidable Rehospitalizations can be downloaded at www.IHI.org.


Keywords: care transitions, STAAR, quality improvement, rehospitalization

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