IBM Watson Health, Bethesda (Dr Henke, Mr Lenhart, Dr Cutler, Dr Goetzel); Institute for Health and Productivity Studies, Johns Hopkins Bloomberg School of Public Health, Baltimore (Mr Berko, Dr Goetzel), Maryland.
J Occup Environ Med. 2018 Mar;60(3):241-247. doi: 10.1097/JOM.0000000000001279.
A large employer partnered with local health care providers to pilot test an intensive nurse care manager program for employees and retirees. We evaluated its impact on health care utilization and costs.
A database was developed containing 2011 to 2015 health care enrollment and claims data for 2914 patients linked to their nurse care manager data. We used a difference-in-difference design to compare health care costs and utilization of members recruited for the pilot program and a propensity-score-matched comparison group.
We found statistically significant reductions in doctors' office visits and prescription drug costs. A return-on-investment analysis determined that the program saved $0.83 for every dollar spent over the 2-year pilot study period.
Employer-driven care management programs can succeed at reducing utilization, although they may not achieve cost neutrality in the short run.
一家大型雇主与当地医疗保健提供商合作，试点测试针对员工和退休人员的强化护士护理经理计划。我们评估了它对医疗保健利用和成本的影响。
开发了一个数据库，其中包含 2011 年至 2015 年 2914 名患者的医疗保健注册和索赔数据，这些患者与他们的护士护理经理数据相关联。我们使用差异中的差异设计来比较试点计划招募的成员的医疗保健费用和利用情况，以及倾向评分匹配的对照组。
我们发现医生就诊次数和处方药费用有统计学意义的减少。投资回报分析确定，在为期两年的试点研究期间，该计划每花费 1 美元就能节省 0.83 美元。
雇主驱动的护理管理计划可以成功地减少利用，但在短期内可能无法实现成本中性。
