The University of Pennsylvania's School of Nursing will attempt to replicate and study its own transitional care model at four other health systems through a $6 million grant from Arnold Ventures, a Houston-based foundation known for investing in Civica Rx.
Four things to know:
1. Leaders at Philadelphia-based Penn Nursing developed the care model, which has proven to reduce readmissions, improve outcomes and lower health costs among Medicare populations in past clinical trials. The program relies on advanced practice registered nurses who work with patients and other care team members to build individualized care plans for older patients leaving the hospital with complex health and social needs.
2. The study will assess the outcomes of 1,600 Medicare patients participating in the transitional care model at nine hospitals affiliated with the following systems:
- Swedish Health Services (Seattle)
- Trinity Health (Livonia, Mich.)
- University of California San Francisco Health
- Veterans Health Administration (Washington, D.C.)
3. Penn Nursing leaders will help implement the program and train employees at all study sites.
4. The research's overall goal is to see if the care model is replicable across hospitals nationwide, which could prove to be a valuable strategy for CMS and other insurers to reduce healthcare costs.