When patients have access to coordinated care through a patient-centered medical home, they are more satisfied and costs are reduced. Research has shown that patients with varied circumstances and needs benefit from high-quality coordinated care — while the community saves money and other resources.
Enhanced Care Management or ECM, a Central Plains pilot program, used nurse and community resource care managers to help people access care and self-manage their chronic disease. Over 2 years, the State of Kansas had a reduction of $5.5 million in claims when compared to the previous 2 years of claims for a randomly selected group of patients.
A Sedgwick County study found that 88% of emergency room admissions could have been avoided if patients had timely access to a primary care provider.
A Central Plains program provided case management services that reduced emergency room admissions by 53%.
Military demonstration projects have shown that providing patients with access to a patient-centered medical home decreased ER visits by 29% and reduced ambulatory-sensitive hospital admissions by 11%. Meanwhile, the patients’ experience improved overall.
A Carnegie Mellon University-led study concluded that…..comprehensive, community-based, patient-centered management [for patients at the end of life] reduced hospital admissions by 38 percent, hospital days by 36 percent and emergency room visits by 30 percent, thereby reducing overall costs by 26 percent [without shortening life].
North Carolina saves “at least $160 million annually” by providing high-quality coordinated care to Medicaid recipients by coordinating care with community networks of physicians, care managers, hospitals, health departments and social service agencies.
One diabetes case management and self-management training program provided diabetes education using culturally competent providers. The program showed improvements in quality-adjusted life expectancy, significantly decreased costs, and decreased incidence of diabetes-related complications over the patients’ lifetimes. Patients in this program ranged from those who were uninsured or receiving local or state assistance, to those who were insured.