Establishing the ROI – Using the State Health Information ... · ESTABLISHING THE ROI ... Benefit...
Transcript of Establishing the ROI – Using the State Health Information ... · ESTABLISHING THE ROI ... Benefit...
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
NCOA’S NETWORK DEVELOPMENT LEARNING COLLABORATIVE (NDLC) RESOURCES FOR CALCULATING ROI
https://www.ncoa.org/resources/webinar-an-easy-to-use-tool-to-
estimate-healthcare-cost-savings-for-cdsmp/
MARYLAND LIVING WELL CENTER OF EXCELLENCE
CDSME ROI
Potential healthcare cost savings per person $ 1,154.32
MD Program delivery cost 219.00
Net Cost Savings 935.32
2017 Number of CDSME 65+ completers 1,018 X $935.32
Estimated savings in Maryland healthcare cost = $1,764,020.69
for CDSME = 427%
NDLC RESOURCES FOR DEVELOPING A VALUE PROPOSITION
• https://www.ncoa.org/resources/developing-
value-proposition-evidence-based-programs-
guide-worksheet/
• Presentation on developing value proposition
https://www.ncoa.org/resources/presentation
-developing-value-proposition/
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.
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.
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.
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.
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.
USING DATA TO TELL YOUR STORY
11 Hospital Health System Results
200+ enrolled from April- December 201767% 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)
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
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 not have windows and
needed a ramp. Now she has new windows and a ramp
was installed on her home.
She was unable to complete her Diabetes Self-Management Workshop, but
she re-enrolled several weeks later and successfully attended all six sessions.
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?