ESTABLISHING THE ROI – USING THE STATE HEALTH INFORMATION SYSTEM TO DOCUMENT HEALTH CARE SAVINGS FOR EVIDENCE-BASED PROGRAMS

MARYLAND LIVING WELL CENTER OF EXCELLENCE (LWCE)

Leigh Ann Eagle, Wendy Farthing and Sue Lachenmayr

NCOA’S NETWORK DEVELOPMENT LEARNING COLLABORATIVE (NDLC) RESOURCES FOR CALCULATING ROI

https://www.ncoa.org/resources/webinar-an-easy-to-use-tool-to-

estimate-healthcare-cost-savings-for-cdsmp/

MARYLAND LIVING WELL CENTER OF EXCELLENCE

CDSME ROI

Potential healthcare cost savings per person $ 1,154.32

MD Program delivery cost 219.00

Net Cost Savings 935.32

2017 Number of CDSME 65+ completers 1,018 X $935.32

Estimated savings in Maryland healthcare cost = $1,764,020.69

for CDSME = 427%

NDLC RESOURCES FOR DEVELOPING A VALUE PROPOSITION

• https://www.ncoa.org/resources/developing-

value-proposition-evidence-based-programs-

guide-worksheet/

• Presentation on developing value proposition

https://www.ncoa.org/resources/presentation

-developing-value-proposition/

LWCE VALUE PROPOSITION

Benefit to Your Organization: Marylanders, regardless of

their age, ethnicity, income or geographic location are

engaged, activated and connected to needed services,

programs, and resources that improve/maintain their

physical and mental health across the continuum of care.

Nationally, 5% of the population accounts for fifty percent

of total medical costs. Diabetes drives the top 5 medical

costs.

LWCE VALUE PROPOSITION CONT’D

LWCE Provides:

• Tools and resources to increase patient engagement and

self-efficacy

• Assessment of social determinants needs and social isolation,

• Interventions and resources to empower your patients to be

better self-managers.

Our team is known and trusted by patients and their families in

the communities you serve. By helping you link to those who

are unreachable, unchangeable, or unmanageable, we will

assist you to provide better care with better health outcomes.

MARYLAND’S HOSPITALS ARE MANDATED TO PROVIDE POPULATION HEALTH UNDER A SINGLE PAYER, CAPITATED RATE

•Evidence-based Programs provide a unique opportunity

to implement skill-building, behavior-change

programming to mitigate, reduce and/or avoid

hospitalization.

•Maryland healthcare partners are focused on their

Return on Investment (ROI).

•Research outcomes on evidence-based programs are

important, but organizations want to know about their

own patients and costs.

PATIENT-SPECIFIC INFORMATION DEMONSTRATES THE VALUE OF PREVENTION/SELF-MANAGEMENT The Maryland LWCE has an innovative partnership with a local hospital and

the state’s Health Information Exchange - CRISP (Chesapeake Regional

Information System for Patients). CRISP tracks patient admission/re-admission

to all Maryland hospitals and Emergency Departments (EDs).

Under our contract, LWCE is able to:

1. Embed referral to evidence-based programs (EBPs) and other

nonclinical services;

2. Report patient engagement/enrollment/completion in EBPs;

3. Document provision of programs and services; and

4. Alert providers of patient’s condition, gaps or needed services.

These reports provide the hospital and LWCE with

real-time information on changes in cost of care.

USING DATA TO TELL YOUR STORY

• Data is used to demonstrate long-term outcomes in hospital

and ED utilization for individuals referred to EBP at 6-months

pre- and post-workshop attendance.

• These reports provide the hospital and LWCE with real time

information on changes in costs of care.

• This information can be used by providers across the state.

Since all Maryland AAAs can become ‘care providers’, this

opens the door to potential partnerships between AAAs

providing EBPs and services and local hospitals, providers and

insurers.

USING DATA TO TELL YOUR STORY

11 Hospital Health System Results

200+ enrolled from April- December 201767% participants reporting increase self-management

69% participants reporting program satisfaction

60% participants reporting weight loss

64% participants reporting decrease in BP

52% participants reporting decrease in % body fat

94 lay leaders trained, with 63% retention rate

Readmission/cost analysis currently underway (CRISP/claims data)

USING DATA TO TELL YOUR STORY

• Local hospital increased budget for FY2019 CDSME,

reporting that referrals from transitions of care nurses to

EBP has resulted in reduction in readmissions

• Implementing Living Well with Hypertension and CDSME demonstrates

controlled hypertension at an estimated cost savings per patient $460

• Depression Screening and enrollment into PEARLS results in an average

$1100 savings in health care costs per patient

BUT – DON’T FORGET TO INCLUDE THE PATIENT IN YOUR STORY

Ms. M attended a Diabetes Self-Management workshop but complained she

felt dizzy and light-headed and was having difficulty staying awake. The leader

took her aside and she explained she had not eaten that day due to lack of

money to purchase food. She was assigned to a Community

Health Worker who was able to connect her with resources

in the area where she could receive food supplementation

on a regular basis.

Ms. M lived in a trailer that did not have windows and

needed a ramp. Now she has new windows and a ramp

was installed on her home.

She was unable to complete her Diabetes Self-Management Workshop, but

she re-enrolled several weeks later and successfully attended all six sessions.

OPEN DISCUSSION –WHAT WORKS IN YOUR STATE/ORGANIZATION?

• How do you share information/data across

organizations and partners?

• What methods do you use for data-sharing and

demonstrating your ROI?

• What advantages do you see in documenting the value of your services/return on investment?