Viva Health, Inc., Birmingham, AL, USA.
The University of Alabama at Birmingham, USA.
Med Care Res Rev. 2024 Feb;81(1):19-30. doi: 10.1177/10775587231197846. Epub 2023 Sep 7.
This study evaluated the impact of an interdisciplinary care teams (IDCT) care management program on cost and quality outcomes using a novel algorithm to identify 400 high-risk patients out of 48,235 Medicare Advantage (MA) beneficiaries. Of the 400, 252 were enrolled in the IDCT care management intervention program, while the remaining 148 were not enrolled. A second comparison group consisted of 660 who were referred to the IDCT program but not selected by the algorithm. The program's effectiveness was evaluated 1-year postintervention. Analyses found that health care costs for members enrolled in the IDCT program were reduced by US$1,121.76 and US$1,625.61 per member per month, respectively, relative to those not enrolled and those enrolled by referral. The cost reduction from the program generated a net savings of US$1.9MM, covering the program's cost. Findings suggest IDCTs can cost-effectively manage populations of high-risk patients with better selection and fostering greater interdependence.
本研究使用一种新算法从 48235 名医疗保险优势（MA）受益人中确定了 400 名高危患者，评估了跨学科护理团队（IDCT）护理管理计划对成本和质量结果的影响。在这 400 名患者中，252 名患者被纳入 IDCT 护理管理干预计划，而其余 148 名患者未被纳入。第二个对照组由 660 名被转介至 IDCT 计划但未被算法选中的患者组成。该计划的有效性在干预后 1 年进行评估。分析发现，与未入组和转介入组的患者相比，参加 IDCT 计划的成员的医疗保健费用分别降低了 1121.76 美元和 1625.61 美元/人/月。该计划的成本降低产生了 190 万美元的净节省，足以覆盖该计划的成本。研究结果表明，IDCT 可以通过更好的选择和促进更大的相互依存关系，以具有成本效益的方式管理高危患者群体。
