Estimated Cost Savings: Everyone With Diabetes Counts (EDC) Program.

Everyone with Diabetes Counts (EDC) is a national disparities reduction program funded by the Centers for Medicare & Medicaid Services to improve outcomes in the underserved minority, diverse, and rural populations. This analysis evaluates West Virginia's pilot program of diabetes self-management education (DSME), one component of EDC. We frequency-matched 422 DSME completers to 1688 others by demographics and enrollment from Medicare fee-for service claims. We estimated savings associated with reduced hospitalizations in multivariable negative binomial models. DSME completers had 29% fewer hospitalizations (adjusted P < .0069). We estimated savings of $35 900 per 100 DSME completers in West Virginia.

Making a Dent in Undiagnosed and Untreated Depression among Older West Virginians.

IMPORTANCE: Depression, a serious and debilitating disease, remains under-diagnosed and inadequately treated among older adults. OBJECTIVE: To describe the prevalence of depression among older West Virginians and report the extent to which primary care providers screen Medicare beneficiaries for depression. METHODOLOGY: Descriptive analysis using 2014 Behavioral Risk Factor Surveillance System to estimate depression prevalence; Medicare Part B claims, 2012 - 2014, to measure depression screening. FINDINGS: In 2014, depression affected 10.1%, 95% CI [8.6%, 11.6%] of older West Virginians. While screening increased, less than 4% of Medicare beneficiaries seen in primary care that year were screened. CONCLUSION: We have a significant opportunity to improve diagnosis, treatment and quality of life for older West Virginians with depression, and Medicare reimbursement for screening is available to primary care providers. Although many older depressed patients can be treated in the primary care setting, integration of behavioral health and primary care has distinct benefits.

Exploratory analysis of the relationship between home health agency engagement in a national campaign and reduction in acute care hospitalization in US home care patients.

RATIONALE, AIMS AND OBJECTIVES: To determine whether US home health agencies that intensively engaged with the 2010 Home Health Quality Improvement National Campaign were more likely to reduce acute care hospitalization (ACH) rates than less engaged agencies. METHOD: We included all Medicare-certified agencies that accessed Campaign resources in the first month of the Campaign and also responded to an online survey of resource utilization at month two. We used the survey data and item response theory to estimate a latent construct we called engagement with the campaign. ACH rates were calculated from the Centers for Medicare & Medicaid Services Outcome and Assessment Information Set for pre- and post-intervention periods (March-November 2009 and 2010, respectively). RESULTS: Staff from 1077 agencies accessed resources in the first month of the Campaign. Of these, 382 provided information about resource use and had 10 or more monthly discharges throughout the measurement periods. Dividing these agencies into quartiles based on engagement score, we found an association between engagement and reduction in ACH rates, P=0.049 (χ(2) for trend). Exploratory path analysis revealed the effect of engagement score on reduction in ACH rate to be partially mediated through reduction in average length of service rates. CONCLUSION: We found evidence that early intensity of engagement with the Campaign, as measured through use of activities and resources, was positively associated with improvement. To continue the investigation of this relationship, future work in this and other campaigns should focus on further development of engagement measures.