Developing an IDS-based disease-management program for the frail elderly.
IDSs that own a health plan or enter a full-risk-sharing contract with a payer are in an position to benefit from developing disease-management programs that reduce acute care admissions. Full-risk assumption allows an IDS to realize cost savings due to more cost-effective care management that offset revenue lost due to reduced acute care services. Crozer-Keystone Health System (CKHS) in Delaware County, Pennsylvania, implemented a disease-management program for frail elderly enrollees in its Medicare + Choice plan, MedCare Plus. Projected first-year savings were estimated at about $619,000 over 1,200 member months. First-year results showed a 36 percent reduction in acute care admissions, with savings of $242,749 over 613 member months. The difference between actual results and projected savings was attributed to social and other factors not accounted for in the cost-benefit analysis. Still, lost revenues from acute care admissions were more than offset by the savings realized.
Baseman
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S
University of Pennsylvania Health System, Philadelphia, USA.
Truxell
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R
D000368:Aged; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D019468:Disease Management; D016330:Frail Elderly; D006299:Health Services for the Aged / Q000191:economics / Q000458:organization & administration; D006801:Humans; D006278:Medicare; D016730:Program Development; D014481:United States