Thank you for the excellent article on the Community-based Care Transitions Program (“Care-transition fumbles highlight CMS' reform challenges,” ModernHealthcare.com, 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.