The Business Case for Adult Disability Care Coordination
Abstract Palsbo SE, Diao G. The business case for adult disability care coordination. Objective To analyze the financial performance of a care coordination program. Design The study used a retrospective pretest, posttest design of 245 beneficiaries. Physical impairment ranged from slight to severe....
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2010-02, Vol.91 (2), p.178-183 |
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| creator | Palsbo, Susan E., PhD Diao, Guoqing, PhD |
| description | Abstract Palsbo SE, Diao G. The business case for adult disability care coordination. Objective To analyze the financial performance of a care coordination program. Design The study used a retrospective pretest, posttest design of 245 beneficiaries. Physical impairment ranged from slight to severe. Setting Minnesota Disability Health Options (MnDHO), a capitated Medicaid program. Participants Medicaid beneficiaries ages 18 to 64 with physical disabilities arising from multiple sclerosis, cerebral palsy, spinal cord injury, or brain injury. Interventions Not applicable. Main Outcomes Measures Change in expenditures, rate of return, and utilization. Results Mean MnDHO monthly expenditures including care coordination increased by a factor of 1.75 ( P |
| doi_str_mv | 10.1016/j.apmr.2009.10.018 |
| format | Article |
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The business case for adult disability care coordination. Objective To analyze the financial performance of a care coordination program. Design The study used a retrospective pretest, posttest design of 245 beneficiaries. Physical impairment ranged from slight to severe. Setting Minnesota Disability Health Options (MnDHO), a capitated Medicaid program. Participants Medicaid beneficiaries ages 18 to 64 with physical disabilities arising from multiple sclerosis, cerebral palsy, spinal cord injury, or brain injury. Interventions Not applicable. Main Outcomes Measures Change in expenditures, rate of return, and utilization. Results Mean MnDHO monthly expenditures including care coordination increased by a factor of 1.75 ( P <.001) over the previous expenditures. Increasing age has a multiplier effect on increased expenditures. Hospitalization rates were unchanged, but the average cost per admission and average length of stay dropped significantly ( P =.017, P =.032, respectively). For people enrolled at least 3 years, annual reductions in medical costs more than paid for the added cost of care coordination, but the savings in Year 3 were about 20% of the savings in the first 2 years. Conclusions Care coordination leads to higher program expenditures for enrollees with moderate physical impairments who encounter access problems, but has little impact on enrollees who are already getting 24-hour care. There is some evidence of adverse selection bias. MnDHO's disability care coordination may not be financially sustainable over the long term.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2009.10.018</identifier><identifier>PMID: 20159118</identifier><identifier>CODEN: APMHAI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Age Factors ; Biological and medical sciences ; Cohort Studies ; Cost-Benefit Analysis ; Disabled Persons - rehabilitation ; Diseases of the osteoarticular system ; Female ; Financial management ; Health Expenditures ; Home Care Services - organization & administration ; Hospitalization - economics ; Humans ; Male ; Medicaid ; Medical sciences ; Middle Aged ; Minnesota ; Miscellaneous ; Miscellaneous. Osteoarticular involvement in other diseases ; Physical Medicine and Rehabilitation ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Rehabilitation ; Rehabilitation - economics ; Retrospective Studies</subject><ispartof>Archives of physical medicine and rehabilitation, 2010-02, Vol.91 (2), p.178-183</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2010 American Congress of Rehabilitation Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-bace79df5b506193f0ffb7f63444e2ad1c13a42e627a66ef6b95e50d2edd417f3</citedby><cites>FETCH-LOGICAL-c440t-bace79df5b506193f0ffb7f63444e2ad1c13a42e627a66ef6b95e50d2edd417f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999309009010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22439949$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20159118$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Palsbo, Susan E., PhD</creatorcontrib><creatorcontrib>Diao, Guoqing, PhD</creatorcontrib><title>The Business Case for Adult Disability Care Coordination</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Palsbo SE, Diao G. The business case for adult disability care coordination. Objective To analyze the financial performance of a care coordination program. Design The study used a retrospective pretest, posttest design of 245 beneficiaries. Physical impairment ranged from slight to severe. Setting Minnesota Disability Health Options (MnDHO), a capitated Medicaid program. Participants Medicaid beneficiaries ages 18 to 64 with physical disabilities arising from multiple sclerosis, cerebral palsy, spinal cord injury, or brain injury. Interventions Not applicable. Main Outcomes Measures Change in expenditures, rate of return, and utilization. Results Mean MnDHO monthly expenditures including care coordination increased by a factor of 1.75 ( P <.001) over the previous expenditures. Increasing age has a multiplier effect on increased expenditures. Hospitalization rates were unchanged, but the average cost per admission and average length of stay dropped significantly ( P =.017, P =.032, respectively). For people enrolled at least 3 years, annual reductions in medical costs more than paid for the added cost of care coordination, but the savings in Year 3 were about 20% of the savings in the first 2 years. Conclusions Care coordination leads to higher program expenditures for enrollees with moderate physical impairments who encounter access problems, but has little impact on enrollees who are already getting 24-hour care. There is some evidence of adverse selection bias. MnDHO's disability care coordination may not be financially sustainable over the long term.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Cost-Benefit Analysis</subject><subject>Disabled Persons - rehabilitation</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Financial management</subject><subject>Health Expenditures</subject><subject>Home Care Services - organization & administration</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Male</subject><subject>Medicaid</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minnesota</subject><subject>Miscellaneous</subject><subject>Miscellaneous. Osteoarticular involvement in other diseases</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Rehabilitation</subject><subject>Rehabilitation - economics</subject><subject>Retrospective Studies</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoO4uLOrf8CD9EU89Vj56I-ACLvjui4seHAFbyGdVDBjT_eY6hbm35tmRgUPewqpPG9VeIqxlxzWHHj9dru2-11aCwCdC2vg7RO24pUUZSv4t6dsBQCy1FrLc3ZBtM3XupL8GTsXwCvNebti7cN3LK5nigMSFRtLWIQxFVd-7qfiQyTbxT5Oh_ySsNiMY_JxsFMch-fsLNie8MXpvGRfP948bD6V959v7zZX96VTCqaysw4b7UPVVVBzLQOE0DWhlkopFNZzx6VVAmvR2LrGUHe6wgq8QO8Vb4K8ZG-Offdp_DkjTWYXyWHf2wHHmUwjZdUqaFUmxZF0aSRKGMw-xZ1NB8PBLMLM1izCzCJsqWVhOfTq1H7uduj_Rv4YysDrE2DJ2T4kO7hI_zihpNZKZ-7dkcMs41fEZMhFHBz6mNBNxo_x8X-8_y_u-jjEPPEHHpC245yGrNlwQ8KA-bKsdtks6NwEOMjfyNmdMA</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Palsbo, Susan E., PhD</creator><creator>Diao, Guoqing, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100201</creationdate><title>The Business Case for Adult Disability Care Coordination</title><author>Palsbo, Susan E., PhD ; Diao, Guoqing, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-bace79df5b506193f0ffb7f63444e2ad1c13a42e627a66ef6b95e50d2edd417f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Cost-Benefit Analysis</topic><topic>Disabled Persons - rehabilitation</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Financial management</topic><topic>Health Expenditures</topic><topic>Home Care Services - organization & administration</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Male</topic><topic>Medicaid</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minnesota</topic><topic>Miscellaneous</topic><topic>Miscellaneous. Osteoarticular involvement in other diseases</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Rehabilitation</topic><topic>Rehabilitation - economics</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Palsbo, Susan E., PhD</creatorcontrib><creatorcontrib>Diao, Guoqing, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Palsbo, Susan E., PhD</au><au>Diao, Guoqing, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Business Case for Adult Disability Care Coordination</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>91</volume><issue>2</issue><spage>178</spage><epage>183</epage><pages>178-183</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><coden>APMHAI</coden><abstract>Abstract Palsbo SE, Diao G. The business case for adult disability care coordination. Objective To analyze the financial performance of a care coordination program. Design The study used a retrospective pretest, posttest design of 245 beneficiaries. Physical impairment ranged from slight to severe. Setting Minnesota Disability Health Options (MnDHO), a capitated Medicaid program. Participants Medicaid beneficiaries ages 18 to 64 with physical disabilities arising from multiple sclerosis, cerebral palsy, spinal cord injury, or brain injury. Interventions Not applicable. Main Outcomes Measures Change in expenditures, rate of return, and utilization. Results Mean MnDHO monthly expenditures including care coordination increased by a factor of 1.75 ( P <.001) over the previous expenditures. Increasing age has a multiplier effect on increased expenditures. Hospitalization rates were unchanged, but the average cost per admission and average length of stay dropped significantly ( P =.017, P =.032, respectively). For people enrolled at least 3 years, annual reductions in medical costs more than paid for the added cost of care coordination, but the savings in Year 3 were about 20% of the savings in the first 2 years. Conclusions Care coordination leads to higher program expenditures for enrollees with moderate physical impairments who encounter access problems, but has little impact on enrollees who are already getting 24-hour care. There is some evidence of adverse selection bias. MnDHO's disability care coordination may not be financially sustainable over the long term.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20159118</pmid><doi>10.1016/j.apmr.2009.10.018</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Age Factors Biological and medical sciences Cohort Studies Cost-Benefit Analysis Disabled Persons - rehabilitation Diseases of the osteoarticular system Female Financial management Health Expenditures Home Care Services - organization & administration Hospitalization - economics Humans Male Medicaid Medical sciences Middle Aged Minnesota Miscellaneous Miscellaneous. Osteoarticular involvement in other diseases Physical Medicine and Rehabilitation Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Rehabilitation Rehabilitation - economics Retrospective Studies |
| title | The Business Case for Adult Disability Care Coordination |
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