PUTTING THE PIECES TOGETHER

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Presentation transcript:

PUTTING THE PIECES TOGETHER

CBCM-UMSJMC Program Savings

CBCM-UMSJMC Program Performance Program Readmission Rate Readmission Rate for High Risk Patients not Enrolled in the Program* This graph trends the readmission rates for three different populations: low-risk patients (red line); high-risk patients in the program (blue line); and the high-risk patients not enrolled in the program (orange line). The primary difference between the two high risk populations was that the program was comprised of high-risk patients going home while the non-program population was largely comprised of high-risk patients being discharged to a facility. There are several interesting takeaways from this graph: 1. The readmission rate for low-risk patients remained fairly stable throughout the two-year period. 2. At the start of the program, there was a significant difference in the readmission rates for the two different high-risk populations. This suggests that at that time there was a much higher readmission risk facing those patients who were being discharged back to their home. 3. The readmission rates for the two different high-risk populations converged over time and the program readmission rate was consistently below the non-program rate for the last several months of the chart. This suggests that the program interventions played a part in removing much of the risk that had been present for high-risk patients going home. 4. The trend lines for the program readmission rate and the readmission rate for low-risk patients essentially converge at the end of the chart. This is encouraging considering that the readmission rate for low-risk patients probably represents a natural floor in the share of readmissions stemming from avoidable utilization. 65% Reduction in Readmissions Note the convergence of the trend lines for the program readmission rate and the readmission rate for high-risk patients not enrolled in the program

Everyone accepts the value of Homecare… $1,433.11 Day of Hospital Care $506.37 Day of Nursing Home Care $293.40 Day of PDN Home Care Source: Health Management Associates (FL Medicaid data)

THANK YOU W. John Langley, M.D., FAAP Senior Vice-President and Chief Medical Officer Maxim Healthcare Services