September 28, 2010 12:00 ET

Statewide Effort Brings Together California Hospitals, Physician Organizations, Other Health Care Providers to Lower Costly and Avoidable Hospital Readmissions

ARC "Avoid Readmissions Through Collaboration" Initiative Helps Hospitals Prepare for Health Reform Requirements

SACRAMENTO, CA--(Marketwire - September 28, 2010) -  A statewide effort in California is bringing hospitals, physician organizations, and other health care providers together to reduce 30 and 90-day readmission rates by 30 percent by December 31, 2013. Known as ARC -- "Avoid Readmissions Through Collaboration" -- the initiative helps hospitals adopt evidence-based models and interventions known to reduce readmissions.

"Avoidable hospital readmissions are a symptom of inefficiency and poor quality that result in millions of wasted health care dollars every year in California," said Bruce Spurlock, MD, coordinator of the initiative and CEO of Convergence Health Consulting.

Ninety percent of Medicare readmissions within 30 days are unplanned and the total cost exceeds $17 billion annually, according to recent studies.

"Fortunately, we have evidence-based models and tools for lowering readmissions and improving transitional care. Hospitals and other providers are anxious to learn about and put these tools into place so that patients don't suffer the risks associated with poorly planned transitions from the hospital back home or to other care settings," said Spurlock.

Already, nearly 150 hospital, medical group, health plan and nursing home leaders from five San Francisco Bay Area counties have met and begun to discuss what will be required to more quickly lower readmission rates and to improve transitional care processes.

ARC will organize "Learning Communities" that include hospitals and other provider organizations (e.g., medical groups/IPAs, home health, long term care, health plans) that want in-depth education -- conferences, peer-to-peer forums and webinars -- that focuses on practical, evidence-based approaches to reducing readmissions. The ARC-sponsored educational events will include regional and national experts.

Within the Learning Communities will be Action Networks consisting of those hospitals and their outpatient partners that receive additional on site and remote support from improvement advisors. Advisors will support Action Network participants through examination of hospital readmission data, review of current discharge processes and facility specific training. Select Action Network participants are also eligible to apply for 2011 planning grants from the Gordon and Betty Moore Foundation.

"Hospitals face intense pressure to lower unplanned readmissions and to improve transitional care," said Debby Rogers, RN, MS, VP Quality and Emergency Services, California Hospital Association. "We are excited about this new collaborative and the opportunity to work together to solve this common challenge."

Medicare already reports hospitals' readmission rates for heart attack, pneumonia and heart failure at But beginning in 2013, hospitals will be penalized one percent of their Medicare reimbursement if readmission rates exceed expected levels. The penalty increases in subsequent years.

"We are seeing tremendous interest from physician groups in working more seamlessly with their hospital partners. The ARC collaborative will provide a structure to accelerate this effort," said Diane Stewart, Director, Performance Improvement, Pacific Business Group on Health. 

Successfully reducing unplanned readmissions and improving care transitions involves several guiding principles that ARC will emphasize: maintaining a patient-centered focus; "getting into the weeds" to better understand the complex discharge planning and transitional process; customizing existing transitional care models to fit a hospital's own culture and systems; and reinforcing effective practices by hospital staff.

Other critical components for effective care transitions include improving patients' capabilities for self-management and medication adherence, as well as encouraging adoption of transitional care technologies.

The three year, one million dollar initiative is funded by the Gordon and Betty Moore Foundation (, with additional support for the project launch from The California Health Care Foundation (

Contact Information