Health Care Innovation Awards: Project Profile


Project Title: "Reducing hospitalizations in Medicare beneficiaries; a collaboration between acute and post-acute care"
Geographic Reach: Kentucky, Tennessee
Funding Amount: $2,449,241
Estimated 3-Year Savings: $8,700,000


Vanderbilt University Medical Center, in partnership with National HealthCare Corporation and two other Post-Acute Care facilities, received an award for a program designed to reduce inpatient re-hospitalization by 17% and improve patient experience for approximately 27,000 Medicare and beneficiaries dually eligible for Medicare and Medicaid in ten counties in Tennessee, including rural and underserved areas. Their project will offer improved hospital discharge planning, evidence-based interventions, and improved clinical responsiveness at post-acute facilities with estimated savings of approximately $8.7 million. Over the three-year period, Vanderbilt University Medical Center's program will train an estimated 30 health care workers and create an estimated 4.6 new jobs. These workers will coordinate discharge planning and care transitions for patients and help integrate clinical responsiveness into post-acute care settings.

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