title: A Case Report: Cornerstone Health Care Reduced the Total Cost of Care Through Population Segmentation and Care Model Redesign.
abstract: Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment. All fully implemented programs delivered between 10% and 16% cost savings. The key area for savings factor was hospitalization, which was reduced by 30% across all programs. The greatest area of cost increase was "other," a category that consisted in large part of hospice services. Full implementation was key; 2 primary care sites that reverted to more traditional models failed to show the same pattern of savings.
authors.affiliation: 1 University of Georgia College of Public Health , Athens, Georgia .
authors.forename: Dale E
authors.initials: DE
authors.lastname: Green
authors.affiliation: 2 Oliver Wyman , Boston, Massachusetts.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Hamory
authors.affiliation: 3 Cornerstone Health Enablement Strategic Solutions , High Point, North Carolina.
authors.forename: Grace E
authors.initials: GE
authors.lastname: Terrell
authors.affiliation: 3 Cornerstone Health Enablement Strategic Solutions , High Point, North Carolina.
authors.forename: Jasmine
authors.initials: J
authors.lastname: O'Connell
mesh_terms: D002908:Chronic Disease; D003191:Comprehensive Health Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D017048:Health Care Costs; D006801:Humans; D018803:Models, Economic; D009657:North Carolina; D017063:Outcome Assessment, Health Care; D000075485:Population Health
keywords: Cornerstone Health Care; chronic disease; cost of care; outcome measures; population health