Pop health intervention, technology lower care costs among Medicaid children

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A new study suggests that population health strategies combined with the use of technology can make a huge difference in outcomes and savings in treating Medicaid-enrolled children.

The authors of the study, published last week in the Journal of the American Medical Association, say it is the largest ever to measure the impact of population health strategies and tools on hospital outcomes among Medicaid-enrolled children.

The research looked at the outcomes of children in the Medicaid program at Children’s Hospital of Philadelphia (CHOP). Results of the study found that among 93,000 children, targeted interventions that combined technology solutions with interdisciplinary integrated care teams led to 50 fewer hospital admissions per month and 3,600 fewer bed days in a year.

CHOP collected data on the study from January 2014 to June 2017, using a set of reporting tools in the patients' electronic medical records, which notified clinicians and staff if their patients visited the emergency department or were admitted to the hospital.

If an ER encounter or hospital admission took place, an integrated care team would follow up with the child’s family to schedule appointments, to assist with locating needed services and to answer questions. The clinical teams assigned to the families also used tech tools to improve care coordination and communication among the team, according to the study.

"As healthcare systems grow larger, integrated care teams and technology that supports those teams are going to be critically important to ensure we're helping families navigate ever more complex institutions, whether adult or pediatric in nature," says David Rubin, MD, director of population health innovation and PolicyLab at CHOP and lead author on the study.

"Fundamentally, what we are talking about is identifying those patients who need the most proactive care, surrounding them with an expert team—from physicians, to nurses, to social workers to navigators—and then equipping that team with supportive technology,” Rubin says. “In doing that, we saw that we can deliver the type of care our patients want while providing value and efficiency throughout the whole healthcare system."

Researchers on the study say the success of this population-level intervention came from the ability to deliver services to families within their existing healthcare system and in strong integrated care teams that used a wide variety of EHR tools.

"Our evaluation shows that a strong, integrated primary care network can serve as an effective vehicle for better coordinating care among large groups of families," says Lisa Biggs, MD, associate chief medical officer of the CHOP Care Network and an author on the study. "Having this type of demonstrable impact is important in continuing to build momentum for the care management resources needed to deliver targeted interventions that improve care in all types of medical settings."

The full JAMA study can be found here.

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