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January 05, 2009
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Success Stories

TMF’s Effect On Texas Health Care (2005—2007)

Nursing Homes

TMF worked intensively with 170 of the over 1,100 nursing homes in Texas to improve the quality of care provided to residents.

The proportions of residents suffering from pressure ulcers, residents who were physically restrained, residents in chronic pain and residents suffering from depression all decreased.

Quality measure rates among nursing homes that worked with TMF on each of the clinical topics:

Timeframe Pressure ulcers Restraints Chronic pain Depression
Baseline (2nd quarter 2004) 12.9% 6.4% 4.6% 11.1
Remeasurement (2nd quarter 2007) 11.3% 3.0% 2.5% 10.2%
Relative Improvement 13% 52% 46% 8%

It is estimated that the lives of hundreds of nursing home residents living in nursing homes working with TMF were improved during this time period. Other factors may have contributed to this improvement, including collaborations at the statewide level among health care providers and partners.

  • 277 residents had less pain.
  • 129 fewer high-risk residents developed a pressure ulcer.
  • 111 fewer residents suffered from depression.
  • 453 fewer residents were physically restrained.
Home Health Agencies

TMF worked intensively with 400 of the over 1,300 home health agencies in Texas to improve the quality of care received and to help patients become more independent.

Clinical topic % of agencies working with TMF on clinical topic showing improvement since January 2005 % of agencies NOT working with TMF showing improvement since January 2005
Acute care hospitalization 45.5% 37.9%
Improvement in dyspnea (difficulty in breathing) 65.5% 49.6%
Improvement in oral medications 68.3% 53.1%
Improvement in pain management 59.8% 46.1%
Hospitals

TMF worked intensively with 32 of the over 300 hospitals in Texas to improve the quality of care received by patients.

The proportion of patients receiving appropriate care for heart failure, acute myocardial infarction (AMI) and pneumonia all increased.

Quality measure rates among nursing homes that worked with TMF on each of the clinical topics:

Timeframe Heart failure AMI Pneumonia
Baseline (4th quarter 2004) 79.2% 81.6% 55.4%
Remeasurement (1st quarter 2007) 89.8% 89.7% 79.9%
Relative in Failure Rate 50.9% 43.9% 54.9%
Physician Practices

TMF assisted 300 practices with the adoption and/or best use of an electronic health record (EHR). During this time period the number of practices doing electronic prescribing, using an EHR and using an EHR for care management increased greatly.

  October 2006 September 2007
Number of practices doing electronic prescribing 27 123
Number of practices using an EHR 59 115
Number of practices using an EHR for care management 4 86

Of the 201 practices that began the project without a contract for an EHR, 80 signed a contract by September 2007.

Hospital Payment Monitoring Program (HPMP)
  • Routine and special study activities are geared to ensuring that Medicare trust fund dollars are spent appropriately in the inpatient setting.
    • TMF’s monitoring of the surveillance system sample of approximately 300 inpatient hospitals recouped over $907,754 from inappropriately billed claims.
    • Through a special project, TMF decreased one-day stays 19% in a group of 18 hospitals. Savings of approximately $7 million were estimated as a result of working with these hospitals to improve their billing practices and reduce inappropriate admissions. The project’s return on investment was $14.50 for each $1 spent.
TMF has received Independent Review Organization accreditation from URAC. TMF has received Health Utilization Management accreditation from URAC. TMF is a GSA Contract Holder.