Supportive Care for Superutilizers of a Managed Care Organization

Supportive Care for Superutilizers of a Managed Care Organization

Ohana Health Plan, Inc., (OHP) is one of the first managed care organizations offering supportive care services targeted to superutilizers. Bristol Hospice Hawaii, LLC, partnered with OHP to provide interdisciplinary supportive care services to home-bound OHP members. The purpose of this study was t...

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Veröffentlicht in:Journal of palliative medicine 2020-11, Vol.23 (11), p.1444-1451
Hauptverfasser: Fernandes, Ritabelle, Fess, Ed G, Sullivan, Sandy, Brack, Mona, DeMarco, Tara, Li, Dongmei
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container_end_page 1451
container_issue 11
container_start_page 1444
container_title Journal of palliative medicine
container_volume 23
creator Fernandes, Ritabelle
Fess, Ed G
Sullivan, Sandy
Brack, Mona
DeMarco, Tara
Li, Dongmei
description Ohana Health Plan, Inc., (OHP) is one of the first managed care organizations offering supportive care services targeted to superutilizers. Bristol Hospice Hawaii, LLC, partnered with OHP to provide interdisciplinary supportive care services to home-bound OHP members. The purpose of this study was to measure symptom relief, satisfaction, resource utilization, and cost savings associated with supportive care. Prospective study. Over 12 months, 27 superutilizer members residing in the community were referred by OHP, 21 members were enrolled into supportive care. Data were collected upon admission and repeatedly thereafter using the Edmonton Symptom Assessment Scale (ESAS) and the Missoula-Vitas Quality of Life Index (MVQOLI). The Family Satisfaction with Advanced Cancer Care (FAMCARE) Scale was administered at discharge. Emergency department (ED) visits and hospital utilization were tracked. Median age was 63 years; more than half had cardiac diagnoses. Majority of members were Hawaiian and other Pacific Islander. Median length of stay in supportive care was 90 days. Five (23%) members enrolled in hospice following supportive care. Symptom improvement occurred in pain (  
doi_str_mv 10.1089/jpm.2019.0288
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Bristol Hospice Hawaii, LLC, partnered with OHP to provide interdisciplinary supportive care services to home-bound OHP members. The purpose of this study was to measure symptom relief, satisfaction, resource utilization, and cost savings associated with supportive care. Prospective study. Over 12 months, 27 superutilizer members residing in the community were referred by OHP, 21 members were enrolled into supportive care. Data were collected upon admission and repeatedly thereafter using the Edmonton Symptom Assessment Scale (ESAS) and the Missoula-Vitas Quality of Life Index (MVQOLI). The Family Satisfaction with Advanced Cancer Care (FAMCARE) Scale was administered at discharge. Emergency department (ED) visits and hospital utilization were tracked. Median age was 63 years; more than half had cardiac diagnoses. Majority of members were Hawaiian and other Pacific Islander. Median length of stay in supportive care was 90 days. Five (23%) members enrolled in hospice following supportive care. Symptom improvement occurred in pain (  &lt; 0.0001), anxiety (  = 0.0052), and shortness of breath (  = 0.0447). This model has shown a 79.5% reduction of ED visits per thousand members and a 75% reduction of hospitalizations per thousand. Overall net savings was 36%. Discussions and documentation of end-of-life wishes increased from 23% to 85%. Supportive care is highly effective in reducing costs associated with superutilizers. 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title Supportive Care for Superutilizers of a Managed Care Organization
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