TROY, N.Y.--(EON: Enhanced Online News)--Newly-published research confirms that a Patient-Centered Medical Home initiative in North Carolina is lowering costs and improving care for Medicaid recipients. The article, “Healthcare Savings with the Patient-Centered Medical Home: Community Care of North Carolina’s Experience,” was published in the online edition of the Population Health Management Journal. “[The study] adds to the preponderance of evidence that the targeted system-wide efforts of Community Care of North Carolina (CCNC) are having a positive impact on Medicaid recipients,” according to the authors.
“CCNC, along with Treo’s other clients, are on the leading edge of improving quality care while lowering costs through effective care management.”
Using two different models, the study examined the economic impact of the CCNC program on Medicaid recipients under age 65 with disabilities and covered a nearly five-year period since CCNC created specialized chronic care programs to serve this population. As noted in the article, disabled Medicaid recipients have complex care needs, account for higher Medicaid costs, and are at risk for more avoidable hospital admissions, readmissions, and ER visits.
Study findings included:
- The authors estimate that enrollment in CCNC produced a cost savings of $184 million over the 4.75 years studied. These savings, which are net of CCNC program costs, represent a 7.87% relative savings from the average per member per month (PMPM) cost.
- The direct effect of program enrollment was associated with statistically significant cost savings, ranging from almost $190.91 PMPM in the first year to $63.74 PMPM in the last study year.
- There was an even greater cost savings, ranging from $229.31 PMPM during 2007 to $92.61 PMPM during 2011, for persons with multiple chronic disease conditions.
- In every year after the first year of the study, the rate of hospitalizations was significantly lower for CCNC-enrolled members, even though their risk scores were higher. Inpatient admission rates declined among CCNC-enrolled members, while increasing among those not enrolled. At the same time, in concert with the emphasis on improved access to physician services, in every year after 2007, the rate of non-acute physician visits by CCNC-enrolled members was significantly higher than for unenrolled.
The study was conducted and the article was authored by Herb Fillmore, Vice President, Strategic Innovations, Treo Solutions; C. Annette DuBard, MD, MPH, Senior Vice President, Informatics & Evaluation, Community Care of North Carolina; Grant A. Ritter, PhD, Senior Scientist, Schneider Institute for Health Policy, Heller School, Brandeis University; and Carlos Jackson, PhD, Assistant Director, Program Evaluation, Community Care of North Carolina.
“Our findings are consistent with prior actuarial studies and more recent research on CCNC,” said Treo’s Herb Fillmore, the article’s lead author. He pointed out that this study also employed more rigorous research methods than previous work, providing evidence that CCNC is having a positive impact on both the Medicaid program and its recipients.
“We’re excited to be adding to the body of knowledge and sharing positive results as the health system moves to one that is valued-based,” said Fillmore. “CCNC, along with Treo’s other clients, are on the leading edge of improving quality care while lowering costs through effective care management.”
For a copy of the article, click here.
About Treo Solutions
Since 2002, Treo Solutions, a healthcare data analytics and business intelligence firm, is the essential partner for anticipating and managing change in healthcare. Treo leverages enhanced data assets to deliver value to its payer and provider clients. Treo’s highly scalable tools, optimized claims database of over 45-million covered lives, and expertise in collaborative care logistics enables clients to make value-informed decisions to create new risk-sharing and total cost-of-care models. Treo’s focused experience and agility allows clients to anticipate—and rapidly react to—a constantly changing market.