SAN FRANCISCO – Blue Shield of California (BSC) and Kaiser Permanente studies have shown that their respective home-based care coordination programs have delivered a clear return on investment.
Both health plans are gearing up for program expansion and further studies supporting ROI.
BSC is in dialogue with other health plans in the state, said Andrew Halpert, senior medical director. He said care coordination is now being viewed in the context of consumer-directed healthcare and as a strategy to “wring out” healthcare costs.
Frequent proactive phone calls and home visits can educate and empower patients to take care of symptoms related to their illnesses, thereby reducing unnecessary hospitalizations. After the success of its pilot, BSC expanded the program to the rest of its commercial population in January 2005. In November 2006, the program was expanded to BSC’s Medicare population. Studies will be conducted to see if this population, given its numbers and patient co-morbidities, reaps greater benefits.
“We’ve been doing the right thing by the patient, and now we’re back up with the business case,” Halpert said.
Kaiser Permanente conducted two studies on home-based palliative care that showed significant decreases in cost through reduced inpatient days. The first study was published in the Journal of Palliative Medicine in October 2003.
“In both studies the palliative care patients received a higher number of home visits by an interdisciplinary team of providers, including physician home visits, than the control groups,” said Kristine Hillary, regional director of Home Care Services for Kaiser’s Southern California Region.
Kaiser expanded its program to the rest of its service areas in southern California upon completion of its second study in 2005. Last year, more than 1,000 patients populated the program.
In August, the Archstone Foundation chose Kaiser’s Bellflower Medical Center’s Palliative Care Service as one of the top six programs in the state to participate in a two-year, nearly $200,000 best practices study.
The center will gather data on pain and symptom control, quality of care and patient satisfaction for 500 patients over the age of 65 and then develop a replicable hospital-based palliative care model.
Partners in Care, the nonprofit research center at the Partners in Care Foundation, will evaluate the project.
Susan Enguidanos, MD, director of research for Partners in Care, said the grant will help measure the program’s impact and success in delivering “high-quality care consistent with the wishes of Kaiser Permanente patients.”