ESTABLISHING THE ROI USING THE STATE HEALTH INFORMATION SYSTEM TO DOCUMENT HEALTH CARE SAVINGS FOR EVIDENCE- BASED PROGRAMS

Transcription

1 ESTABLISHING THE ROI USING THE STATE HEALTH INFORMATION SYSTEM TO DOCUMENT HEALTH CARE SAVINGS FOR EVIDENCE- BASED PROGRAMS MARYLAND LIVING WELL CENTER OF EXCELLENCE (LWCE) Leigh Ann Eagle, Wendy Farthing and Sue Lachenmayr

2 NCOA S NETWORK DEVELOPMENT LEARNING COLLABORATIVE (NDLC) RESOURCES FOR CALCULATING ROI

3 MARYLAND LIVING WELL CENTER OF EXCELLENCE CDSME ROI Potential healthcare cost savings per person $ 1, MD Program delivery cost Net Cost Savings Number of CDSME 65+ completers 1,018 X $ Estimated savings in Maryland healthcare cost = $1,764, for CDSME = 427%

4 NDLC RESOURCES FOR DEVELOPING A VALUE PROPOSITION Presentation on developing value proposition -developing-value-proposition/

5 LWCE VALUE PROPOSITION Benefit to Your Organization: Marylanders, regardless of their age, ethnicity, income or geographic location are engaged, activated and connected to needed services, programs, and resources that improve/maintain their physical and mental health across the continuum of care. Nationally, 5% of the population accounts for fifty percent of total medical costs. Diabetes drives the top 5 medical costs.

6 LWCE VALUE PROPOSITION CONT D LWCE Provides: Tools and resources to increase patient engagement and self-efficacy Assessment of social determinants needs and social isolation, Interventions and resources to empower your patients to be better self-managers. Our team is known and trusted by patients and their families in the communities you serve. By helping you link to those who are unreachable, unchangeable, or unmanageable, we will assist you to provide better care with better health outcomes.

7 MARYLAND S HOSPITALS ARE MANDATED TO PROVIDE POPULATION HEALTH UNDER A SINGLE PAYER, CAPITATED RATE Evidence-based Programs provide a unique opportunity to implement skill-building, behavior-change programming to mitigate, reduce and/or avoid hospitalization. Maryland healthcare partners are focused on their Return on Investment (ROI). Research outcomes on evidence-based programs are important, but organizations want to know about their own patients and costs.

8 PATIENT-SPECIFIC INFORMATION DEMONSTRATES THE VALUE OF PREVENTION/SELF-MANAGEMENT The Maryland LWCE has an innovative partnership with a local hospital and the state s Health Information Exchange - CRISP (Chesapeake Regional Information System for Patients). CRISP tracks patient admission/re-admission to all Maryland hospitals and Emergency Departments (EDs). Under our contract, LWCE is able to: 1. Embed referral to evidence-based programs (EBPs) and other nonclinical services; 2. Report patient engagement/enrollment/completion in EBPs; 3. Document provision of programs and services; and 4. Alert providers of patient s condition, gaps or needed services. These reports provide the hospital and LWCE with real-time information on changes in cost of care.

9 USING DATA TO TELL YOUR STORY Data is used to demonstrate long-term outcomes in hospital and ED utilization for individuals referred to EBP at 6-months pre- and post-workshop attendance. These reports provide the hospital and LWCE with real time information on changes in costs of care. This information can be used by providers across the state. Since all Maryland AAAs can become care providers, this opens the door to potential partnerships between AAAs providing EBPs and services and local hospitals, providers and insurers.

10 USING DATA TO TELL YOUR STORY 11 Hospital Health System Results 200+ enrolled from April- December % participants reporting increase self-management 69% participants reporting program satisfaction 60% participants reporting weight loss 64% participants reporting decrease in BP 52% participants reporting decrease in % body fat 94 lay leaders trained, with 63% retention rate Readmission/cost analysis currently underway (CRISP/claims data)

11 USING DATA TO TELL YOUR STORY Local hospital increased budget for FY2019 CDSME, reporting that referrals from transitions of care nurses to EBP has resulted in reduction in readmissions Implementing Living Well with Hypertension and CDSME demonstrates controlled hypertension at an estimated cost savings per patient $460 Depression Screening and enrollment into PEARLS results in an average $1100 savings in health care costs per patient

12 BUT DON T FORGET TO INCLUDE THE PATIENT IN YOUR STORY Ms. M attended a Diabetes Self-Management workshop but complained she felt dizzy and light-headed and was having difficulty staying awake. The leader took her aside and she explained she had not eaten that day due to lack of money to purchase food. She was assigned to a Community Health Worker who was able to connect her with resources in the area where she could receive food supplementation on a regular basis. Ms. M lived in a trailer that did needed a ramp. Now she has was installed on her home. not have windows and new windows and a ramp She was unable to complete her Diabetes Self-Management Workshop, but she re-enrolled several weeks later and successfully attended all six sessions.

13 OPEN DISCUSSION WHAT WORKS IN YOUR STATE/ORGANIZATION? How do you share information/data across organizations and partners? What methods do you use for data-sharing and demonstrating your ROI? What advantages do you see in documenting the value of your services/return on investment?