In a recent article published in JAMA Network Open, VSSL members Dr. Leah Marcotte (first author) and Joshua Liao (senior author) led a team including other VSSL team members --- Dr. Ashok Reddy and VSSL Policy and Care Delivery Immersive Participants Drs. Sophie Miller and Carly Hudelson -- in evaluating trends in Transitional Care Management (TCM) services use nationwide between 2013 and 2018.
As noted in a recent VSSL Issue Brief by Drs. Hudelson and Marcotte, TCM was implemented by the Centers for Medicare and Medicaid Services (CMS) in 2013 to better compensate outpatient primary care providers and their teams for managing care transitions after patients are discharged from hospitals.
The JAMA Network Open analysis by Drs. Marcotte, Liao, and team build upon this point and recognize care transitions after hospital discharge is one key aspect of improving health care value. As the team notes, "Early evidence suggested that TCM can be beneficial ... though uptake was low" and "little is known about national trends in TCM use over an extended period, particularly amid intensifying shifts toward value-based payment and care...".
TCM use has increased steadily over six years
Most services were performed by primary care physicians in office settings
The number of TCM denials decreased over time
These results substantiate Medicare’s efforts to focus on TCM while also highlighting the need for future work evaluating these services (e.g., their impact of patient outcomes; the strategies that providers use to deliver these services, and facilitators and barriers to their use).