Assistance programs for chronically-ill patients can cut costs

Focus is on care coordination, direct communication

The use of care coordinators to assist insured individuals with chronic conditions can dramatically lower the cost of care, according to a blog post at Health Affairs. The chronically ill employee population can account for as much as 40 percent of an organization's entire healthcare costs.

Boeing, one of the biggest employers in the western U.S., offers what is known as an intensive outpatient care program (IOCP) for both its active employees and retirees. The program includes medical homes and around-the-clock access to caregivers, and eventually cut costs of that particular patient population by 20 percent, the post noted.

Several employer groups in California, including the California Public Employees' Retirement System (CalPERS) and Pacific Gas and Electric Company, also followed suit. CalPERS has long experimented with different payment models, such as reference pricing for joint replacement procedures.

The program is focused on seven different principles, including enhanced communications with chronically ill patients and an action plan to improve their health, the post said.. A CMS Innovation Center grant eventually helped fund the program to cover 15,000 Medicare enrollees in five states, according to the post.

The highest-risk patients had a 21 percent reduction in average monthly cost of care, the post noted. They also experienced a 55 percent decrease in emergency department visits compared to the quarter before entering an IOCP practice to the third quarter after a patient was enrolled. Inpatient admissions also dropped.

Once CMS ended funding for the program, 90 percent of the participants kept it in place. "Ultimately, the program had a lasting impact on changing the way the participating providers practice medicine, and the way patients care for themselves," the post said.

To learn more:
- here's the post

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