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NEW DIRECTIONS AN INTENSIVE CASE MANAGEMENT PROGRAM

NEW DIRECTIONS AN INTENSIVE CASE MANAGEMENT PROGRAM. Frequent Users of Healthcare Initiative Meeting September 2006. DATA COLLECTED. At enrollment, 6 months, 18 months: FUI Demographics & Functional Status FUI assessment tools (Lehman Qof L, SF12, Stages of Change).

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NEW DIRECTIONS AN INTENSIVE CASE MANAGEMENT PROGRAM

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  1. NEW DIRECTIONSAN INTENSIVE CASE MANAGEMENT PROGRAM Frequent Users of Healthcare Initiative Meeting September 2006

  2. DATA COLLECTED At enrollment, 6 months, 18 months: • FUI Demographics & Functional Status • FUI assessment tools (Lehman Qof L, SF12, Stages of Change)

  3. DATA COLLECTED (cont’d) For Prior Year, Yr. 1, Yr. 2, and Yr. 3: • # of ED visits, admissions, hospital days, clinic visits • Direct costs* for ED, inpatient, outpatient care • # of ambulance rides • Mental health contacts • DADS contacts * Direct Costs = Costs for direct care only, no overhead, administrative, or indirect costs

  4. DATA COLLECTED (cont’d) • Staff contact log • Disenrollment log

  5. METHODOLOGY • Compare Prior Yr. to Yr. 1, Yr. 2, & Yr. 3 • Eventually compare a control group of 40 clients to the case managed group of clients

  6. ANALYSIS #1 COMPARE Prior Year vs. Yr 1, Yr. 2, and Yr. 3 • Percent change in visits*/admits/hospital days • Number of visits/admits/hospital days • Percent change in direct costs of ED/inpt./outpt. care • Direct costs in dollars of ED/inpt./outpt. care * Visits = ED, Outpt, MH, DADS visits

  7. ANALYSIS #2 • Separate clients by those that were successful vs. unsuccessful • Successful = ED visits decreased below the threshold for program (i.e. less than 8 visits / year) • Unsuccessful = ED visits continue with more than 8 ED visits / year • Complete analysis #1 for both groups

  8. RESULTS – Hospital B • 46 Clients followed for 2 years • 85% Success Rate (39 out of 46 reduced ED visits to < 8) • Successful Clients (39) • ED visits decreased80% in Yr. 2 • Hospital & ED Costs decreased (-$98,234) in Yr. 2 • 39 clients = 40% of total case load • For total case load of current program - costs would decrease by ~$245,500 for all clients

  9. RESULTS – Hospital B(cont’d) • Unsuccessful Clients (7) • ED visits increased in Yr. 1 by 18%, decreased only 3% in Yr.2 • ED costs increased in Yr. 1 (52%) and Yr. 2 (65%) • Hospital and ED costs increased in Yr. 1 (+$39,000)and Yr. 2 (+$68,700) • In Yr. 2 outpatient costs increased more for these 7 clients than all 39 successful clients(~$57,000 vs. $23,500)

  10. RESULTS Successful Clients(85%) – Hospital B Change in ED Utilization & Costs – Yr 1 & Yr 2

  11. RESULTS Unsuccessful Clients (15%) – Hospital B Change in ED Utilization & Costs – Yr 1 & Yr 2

  12. RESULTSSuccessful Clients (85%) – Hospital BChange in Hosp. & Outpt. Costs --Yr 1 & Yr 2

  13. RESULTSUnsuccessful Clients (15%) – Hospital BChange in Hosp. & Outpt. Costs --Yr 1 & Yr 2

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