scholarly journals Health Care Cost Analyses for Exploring Cost Savings Opportunities in Older Patients: Longitudinal Retrospective Study

JMIR Aging ◽  
10.2196/10254 ◽  
2018 ◽  
Vol 1 (2) ◽  
pp. e10254 ◽  
Author(s):  
Stephen Agboola ◽  
Mariana Simons ◽  
Sara Golas ◽  
Jorn op den Buijs ◽  
Jennifer Felsted ◽  
...  
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
Older Patients ◽  
Health Care Cost ◽  
Cost Savings ◽  
Cost Analyses

scholarly journals Maximizing Potentially Avoidable Hospitalizations and Cost Savings Beyond Targeting the Most Costly Patients (Preprint)

2018 ◽  
Author(s):  
Mariana Simons ◽  
Sara Golas ◽  
Stephen Agboola ◽  
Jorn op den Buijs ◽  
Jennifer Felsted ◽  
...  
Keyword(s):  
Health Care ◽  
Older Patients ◽  
Health Care Organizations ◽  
Health Care Cost ◽  
Cost Savings ◽  
Categorical Variables ◽  
Care Utilization ◽  
Potential Cost ◽  
Great Opportunity ◽  
Avoidable Hospitalizations

BACKGROUND Many health care organizations use value-based care strategies that include population health management programs and data analytics to stratify their population and identify high-risk and high-cost patients. Most of these programs target the top 5% most expensive patients. However, little is known about these patients prior to reaching the top 5% of cost, or how their characteristics change over time. To address these gaps, we analyzed the differences in characteristics of patients from 3 different cost segments over 5 years (2011-2015). OBJECTIVE To evaluate potentially avoidable hospitalizations and associated savings in the health care cost of older patients using Personal Emergency Response Service (PERS). METHODS We conducted a retrospective, longitudinal, multicenter study to evaluate potentially avoidable hospitalizations of 2643 older patients over 5 years (2011-2015). All patients had at least one inpatient and/or outpatient encounter, and at least one episode of home health care during the study period. Additionally, all patients used PERS at home anytime during the study period. We ranked patients by their annual health care cost and then grouped them into the following segments for each respective year: T-segment constitutes the top 5% most expensive patients; M-segment comprises the middle 45% of patients; B-segment includes the bottom 50% least expensive patients. We then evaluated differences in the characteristics of patients in the B-, M- and T-cost segments in each study year. Continuous variables were compared by t test (two-tailed) for normally distributed variables and Kruskal-Wallis Rank Sum test for skewed variables. The chi-square test was used for categorical variables. RESULTS The three cost segments differed significantly each year (P<.05) with respect to: demographics (age, education), PERS utilization (Incidents, ER transport), health care utilization (hospitalizations, length of stay, 30-, 90-, and 180-day readmissions, outpatient encounters) and medical conditions (number of conditions, Charlson Comorbidity Index). Further, we analyzed the number of potentially avoidable hospitalizations (as defined by CMS) and associated cost savings in each segment. All hospitalizations occurred among patients in the T- and M-segments while the B-segment was hospitalization-free each year. The percentage of avoidable hospitalizations in the M-segment compared with the T-segment was 3 times greater (75% vs 25%, P<.001). While the potential cost saving from avoidable hospitalizations in the entire population increased from $3.0M to $8.2M (2011-2015), the majority of these cost savings were in the M-segment compared with the T-segment (60% vs 40%, P<.001). CONCLUSIONS Although many health care organizations target intensive and costly interventions to their most expensive patients, this analysis suggests there is untapped potential to control costs and improve care beyond focusing on the highest cost patients. Namely, targeting patients in the middle cost segment may offer great opportunity for population management programs to maximize both potentially avoidable hospitalizations and cost savings.

scholarly journals Health Care Cost Analyses for Exploring Cost Savings Opportunities in Older Patients: Longitudinal Retrospective Study (Preprint)

2018 ◽  
Author(s):  
Stephen Agboola ◽  
Mariana Simons ◽  
Sara Golas ◽  
Jorn op den Buijs ◽  
Jennifer Felsted ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Annual Cost ◽  
Older Patients ◽  
Health Care Organizations ◽  
Health Care Cost ◽  
Cost Savings ◽  
Study Population ◽  
The Cost ◽  
Care Costs

BACKGROUND Half of Medicare reimbursement goes toward caring for the top 5% of the most expensive patients. However, little is known about these patients prior to reaching the top or how their costs change annually. To address these gaps, we analyzed patient flow and associated health care cost trends over 5 years. OBJECTIVE To evaluate the cost of health care utilization in older patients by analyzing changes in their long-term expenditures. METHODS This was a retrospective, longitudinal, multicenter study to evaluate health care costs of 2643 older patients from 2011 to 2015. All patients had at least one episode of home health care during the study period and used a personal emergency response service (PERS) at home for any length of time during the observation period. We segmented all patients into top (5%), middle (6%-50%), and bottom (51%-100%) segments by their annual expenditures and built cost pyramids based thereon. The longitudinal health care expenditure trends of the complete study population and each segment were assessed by linear regression models. Patient flows throughout the segments of the cost acuity pyramids from year to year were modeled by Markov chains. RESULTS Total health care costs of the study population nearly doubled from US $17.7M in 2011 to US $33.0M in 2015 with an expected annual cost increase of US $3.6M (P=.003). This growth was primarily driven by a significantly higher cost increases in the middle segment (US $2.3M, P=.003). The expected annual cost increases in the top and bottom segments were US $1.2M (P=.008) and US $0.1M (P=.004), respectively. Patient and cost flow analyses showed that 18% of patients moved up the cost acuity pyramid yearly, and their costs increased by 672%. This was in contrast to 22% of patients that moved down with a cost decrease of 86%. The remaining 60% of patients stayed in the same segment from year to year, though their costs also increased by 18%. CONCLUSIONS Although many health care organizations target intensive and costly interventions to their most expensive patients, this analysis unveiled potential cost savings opportunities by managing the patients in the lower cost segments that are at risk of moving up the cost acuity pyramid. To achieve this, data analytics integrating longitudinal data from electronic health records and home monitoring devices may help health care organizations optimize resources by enabling clinicians to proactively manage patients in their home or community environments beyond institutional settings and 30- and 60-day telehealth services.

Problems in the Evaluation of Occupational Health Promotion Programs: A Case Analysis

1988 ◽  
Vol 3 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Kenneth J. Smith ◽  
George S. Everly
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Occupational Health ◽  
Health Care Cost ◽  
Social Science Research ◽  
Cost Savings ◽  
Science Research ◽  
Analysis Of Covariance ◽  
Occupational Health Promotion ◽  
Final Sample

This study investigates, in a case study setting, whether participation in the Kimberly-Clark Corporation Health and Weight Loss Program can be associated with reduced participant health care claims. A pretest, post-test comparison group research design is utilized to ascertain whether there have been any measurable health care cost savings for participants versus their non-participating matched employee counterparts. The significance of any measured differences is then tested through analysis of variance and analysis of covariance. In addition, results are reported from tests designed to assess whether any specific employee sub-populations appeared to differentially benefit from program participants in terms of reduced health care cost incurrence. Finally, tests are run to provide further assurance that those potential test subjects who were excluded from the final sample did not systematically differ from the final sample subjects. This paper also illustrates, with references to the present study, the difficulties of adapting behavioral and social science research techniques to actual occupational health promotion settings.

Issues for the Next Generation of Health Care Cost Analyses

Medical Care ◽  
2009 ◽  
Vol 47 (Supplement) ◽  
pp. S109-S114 ◽  
Author(s):  
Anirban Basu ◽  
Willard G. Manning
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Next Generation ◽  
Cost Analyses

Where Are the Health Care Cost Savings With Bariatric Surgery in Obesity Management?

JAMA Surgery ◽  
2014 ◽  
Vol 149 (1) ◽  
pp. 5 ◽  
Author(s):  
Allison B. Goldfine ◽  
Ashley Vernon ◽  
Michael Zinner
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Health Care Cost ◽  
Cost Savings ◽  
Obesity Management

Potential Health Care Cost Savings Associated With Early Treatment of Multiple Sclerosis Using Disease-Modifying Therapy

2011 ◽  
Vol 33 (7) ◽  
pp. 914-925 ◽  
Author(s):  
Suellen M. Curkendall ◽  
Cheng Wang ◽  
Barbara H. Johnson ◽  
Zhun Cao ◽  
Ronald Preblick ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Early Treatment ◽  
Health Care Cost ◽  
Cost Savings ◽  
Potential Health ◽  
Disease Modifying Therapy ◽  
Disease Modifying

scholarly journals POTENTIAL HEALTH CARE COST SAVINGS FROM PCR-BASED RAPID DIAGNOSIS OF ENTEROVIRAL MENINGITIS. † 821

1996 ◽  
Vol 39 ◽  
pp. 139-139 ◽  
Author(s):  
José R Romero ◽  
Steven H Hinrich ◽  
Stephen J Cavalieri ◽  
Deborah Perry ◽  
J. Smith Leser ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Cost Savings ◽  
Rapid Diagnosis ◽  
Potential Health ◽  
Enteroviral Meningitis

Increasing Biosimilar Utilization at a Pediatric Inflammatory Bowel Disease Center and Associated Cost Savings: Show Me the Money

2021 ◽  
Author(s):  
Grant A Morris ◽  
Megan McNicol ◽  
Brendan Boyle ◽  
Amy Donegan ◽  
Jennifer Dotson ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Patient Outcomes ◽  
Bowel Disease ◽  
Health Care Cost ◽  
Cost Savings ◽  
The United States ◽  
Physician Global Assessment ◽  
Sustained Improvement ◽  
Inflammatory Bowel

Abstract Background Tumor necrosis factor-alpha inhibitors (anti-TNFs) are a primary treatment for inflammatory bowel disease. Pharmaceutical expenditures and usage of specialty drugs are increasing. In the United States, biosimilars continue to be underutilized, despite opportunities for health care cost savings. Through quality improvement (QI) methodology, we aimed to increase biosimilar utilization among eligible patients initiating intravenous (IV) anti-TNF therapy and describe patient outcomes and associated cost savings. Methods Beginning in July 2019, all patients initiating IV anti-TNF therapy were identified and tracked. Using the Institute of Healthcare Improvement Plan-Do-Study-Act cycle, a four-stage problem-solving model used for carrying out change, we trialed interventions to increase biosimilar utilization, including provider, staff, and family education, and utilization of a clinical pharmacist and insurance specialist. Statistical process control charts were used to show improvement over time. Patients’ clinical outcome and cost savings were reviewed. Results Using QI methodology, we increased biosimilar utilization from a baseline of 1% in June 2019 to 96% by February 2021, with sustained improvement. The originator (infliximab) was the insurance company’s preferred product for 20 patients (20%). Patient outcomes (IV anti-TNF levels, absence of antidrug antibodies, and physician global assessment) between biosimilars and originators were similar. Estimated cost savings over the project duration were nearly $381,000 (average sales price) and $651,000 (wholesale acquisition cost). Conclusions Through QI methodology, we increased biosimilar utilization from 1% to 96% with sustained improvement, without compromising patient outcomes or safety. Estimated cost savings were substantial. Similar methodology could be implemented at other institutions to increase biosimilar utilization and potentially decrease health care costs.

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