Barb Simons, RN Cate Ranheim, MD October 2010. Madison, WI. Overview :. The Need The Program The Patients The Analysis. Defining the Needs for a Solution: . PATIENTS: ED is not the right care for increasing chronic care management needs CLINICIANS: under or over-treating ED patients
Cate Ranheim, MD
-Lack of primary care provider -Transportation
-Mental Illness - Insurance
Lack of primary care provider
*Each identified in 15% of population
Program patients sought Meriter emergency services 138 times in the 10 months before the program started.
Over $86K COST savings potential from these visits alone*.
*Based on Medicaid reimbursement for ED visits of $0.13/$1.00 charge
November 2009 Underserved
Helping Educate and Link the Homeless (HEALTH) Program is born:
HEALTH Program Logistics Underserved
~ 718 hours
* Madison market -based
*Direct expenses only: value of HEALTH Hut building or utilities not included
**Time frame = 6 months
The Patients Underserved
PRIMARY DIAGNOSIS CATEGORY:
Secondary Diagnosis Group
Primary Diagnosis Group
HEALTH Patients Underserved
Total Visits: 393
The Analysis Underserved
Hypertension, Depression, Anxiety, Type II Diabetes
Value: avoiding unnecessary ED visits, reducing need for I/P admissions
Where do the underserved go for care? Underserved
HEALTH Program Participants
Costs = total direct expenses only (salaries, supplies, bus passes, equipment) and excludes building depreciation, overhead, etc.
Average Inpatient cost of care is specific to diagnosis bucket (i.e., Service Line)
The greater the ALOS and Median Inpatient Cost of Care the greater the avoided cost opportunity: analyze your current volumes to estimate your potential savings
*all patient and cost data listed here is fictitious
1. Gather ingredients from Finance Department:
2. Calculate your current costs for these patients to date using the above data
3. Use the formula presented to determine your cost reduction potential
4. If the cost of program startup – donations is less than #3, consider implementing an off-site indigent care program like HEALTH.
Thank you to our donors! Underserved
St. Vincent de Paul
Association of Spiritual Caregivers
Wisconsin Medical Project
Dr. Bernie Micke
Dr. Jack Kenney
Nicole Heide, RN
Mandy McGowan, RN
McGovern & Sons
Jo Hoffman/Ellen Boyce
Meriter Medical Staff Office
Melissa Strayer, for data analysis and volunteer time!
Source: Effects of Specific Comorbidities on Outcomes Controlling for Demographic, Insurance, and Other Clinical Factors of Adult, Nonmaternal Patients Who Were Hospitalized in California in 1992 (n = 1,779,167)
Elixhauser, Anne; Steiner, Claudia; MD, MPH; Harris, D; Coffey, Rosanna. Comorbidity Measures for Use with Administrative Data.
Medical Care. 36(1):8-27, January 1998.