Mobile Integrated Healthcare Intervention and Impact Analysis with a Medicare Advantage Population.

Mobile Integrated Healthcare (MIH) is a patient-centered, innovative delivery model offering on-demand, needs-based care and preventive services, delivered in the patient's home or mobile environment. An interprofessional MIH clinical team delivered a care coordination program for a Medicare Advantage Preferred Provider Organization that was risk assigned prior to intervention to target the highest risk members. Using claims and eligibility data, 6 months of pre-program experience and 6 months of program-influenced experience from the intervention cohort was compared to a propensity score-matched comparison cohort to measure impact. The intervention led to a reduction in inpatient and emergency department utilization, resulting in net savings amount totals of $2.4 million over the 6 months of the program. After accounting for the costs of implementing the program, the intervention produced a return on investment of 2.97. Additionally, high patient activation and experience lend strength to this MIH intervention as a promising model to reduce utilization and costs while keeping patient satisfaction high.

Mobile Integrated Healthcare: Preliminary Experience and Impact Analysis with a Medicare Advantage Population.

Background: Mobile Integrated Healthcare (MIH) is a novel, patient-centered approach to population management. This concept creates a needs-matched, time appropriate assignment of one or more members of a multi-professional clinical team to care for patients on a scheduled or unscheduled basis. The selection of the site of care for scheduled interventions is driven by patient choice and, most often occurs in the patient's home; unscheduled interventions are guided by a 5-point triage system and, based on acuity, may be treated in the home, primary care office, urgent care or, rarely, in an emergency department. Methods: An MIH team was assigned to deliver a care coordination program for a Medicare Advantage PPO (MAPPO) population (55% female, 71.2 years mean age), with risk assignment and interventions designed to affect potentially avoidable utilization of Emergency Medical Services (EMS), emergency department, and medical inpatient admissions. Patients participating in the MIH program were compared with contemporaneous, risk-matched non-participants as well as to actuarially expected cost and utilization based on historical claim experience. Results: All measured trends demonstrated favorable results for patients participating in the MIH program when compared against a matched cohort: 19% decrease in emergency department per member per month (PMPM) cost, 21% decrease in emergency department utilization, 37% decrease in inpatient PMPM cost, 40% decrease inpatient utilization, all measures reached statistical significance. Member experience satisfaction scores and patient activation measures also showed favorable preliminary trends. Conclusion: This initial impact analysis of a MIH care coordination program for this MAPPO population demonstrates promising trends regarding utilization, cost, member experience and patient activation. These preliminary findings indicate both that implementation of such a program is feasible and strongly suggest meritorious impacts upon the health, experience and cost of care for the population.

An Innovative Approach to Health Care Delivery for Patients with Chronic Conditions.

Although the health care reform movement has brought about positive changes, lingering inefficiencies and communication gaps continue to hamper system-wide progress toward achieving the overarching goal-higher quality health care and improved population health outcomes at a lower cost. The multiple interrelated barriers to improvement are most evident in care for the population of patients with multiple chronic conditions. During transitions of care, the lack of integration among various silos and inadequate communication among providers cause delays in delivering appropriate health care services to these vulnerable patients and their caregivers, diminishing positive health outcomes and driving costs ever higher. Long-entrenched acute care-focused treatment and reimbursement paradigms hamper more effective deployment of existing resources to improve the ongoing care of these patients. New models for care coordination during transitions, longitudinal high-risk care management, and unplanned acute episodic care have been conceived and piloted with promising results. Utilizing existing resources, Mobile Integrated Healthcare is an emerging model focused on closing these care gaps by means of a round-the-clock, technologically sophisticated, physician-led interprofessional team to manage care transitions and chronic care services on-site in patients' homes or workplaces.