Pacific Business Group on Health (PBGH) policy researchers in Health Affairs discuss results from their Intensive Outpatient Care Program (IOCP), which was first implemented at Boeing in 2009. Soon thereafter, a pilot program started in the California Public Employees’ Retirement System (CalPERS) and Pacific Gas and Electric Company. Through a CMS Innovation Center grant, the program was expanded to include 15,000 Medicare beneficiaries in five states.

Program Elements
Through retrospective utilization review and predictive risk modeling, IOCP employs embedded care coordinators within physician practices to identify patients with chronic conditions. In conjunction with the care team, enrolled patients complete a Shared Action Plan of their health goals. Patients enrolled in the program have 24/7 access to services, with the care coordinator notified the next business day if services are used. Care coordinators communicate with patients on a monthly basis and serve as a conduit for ancillary services, including home health, behavioral health and transportation.

Results
A Millman and PBGH analysis of the Medicare beneficiaries found that on average, program participants had a 37% higher level of patient activation, a 33% improvement in well-being as measured by the PHQ-9, and an improvement in cognitive and physical functioning as measured by the VR-12.

“Any increase in these scores are particularly noteworthy as they typically decline in senior populations with a high burden of chronic illnesses,” the researchers said.

Over a 12-month period, the researchers found that the highest risk patient group had a 21% reduction in the cost of care on a per member per month basis. And in addition to reductions in admissions and bed days, emergency room visits declined by 55%.

“In working with a multitude of physician practices over the past six years, we have developed effective training and staff education modules that can be instituted in a variety of settings,” the researchers said. “Ultimately, the program had a lasting impact on changing the way the participating providers practice medicine, and the way patients care for themselves.”

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