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U of M evaluation finds Health Care Homes saved $1 billion over 5 year period

Tuesday, February 9, 2016  
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U of M evaluation finds Health Care Homes saved $1 billion over 5 year period
Health care homes also stood out in range of clinical quality

MINNEAPOLIS / ST. PAUL (February 9, 2016) – A new University of Minnesota evaluation of Health Care Homes found that over a five year evaluation period the model – emphasizing collaboration among care providers, families and patients – saved Medicaid and Medicare approximately $1 billion. At the same time, clinics participating in a health care home model of care outperformed other clinics on quality measures.

The results come from a Minnesota Department of Health (MDH) funded evaluation of health care homes done in collaboration with the Minnesota Department of Human Services (DHS) led by investigator Douglas Wholey, Ph.D., professor of health policy and management from the University of Minnesota School of Public Health Division of Health Policy & Management.

A summary of the 2016 U of M evaluation can be found here.

The complete 2016 U of M evaluation can be found here.

Additional findings suggest potentially significant savings if the Medicaid, Medicare, and Dual Eligible patients who were not in a health care home during this period were in a health care home.

"Having had the opportunity to closely observe Minnesota’s Health Care Home initiative during our evaluation of it, I am impressed by the positive results, thorough planning, and effective implementation,” said Wholey.

The health care home program is a cornerstone of Minnesota’s 2008 bipartisan health reform efforts. Within a health care home, primary care providers, families, and patients work in partnership to improve health outcomes and quality of life for patients, including those with chronic conditions or disabilities. The Health Care Homes program is an effort to transform primary care. Certified health care homes strive to place patients and families at the center of their care and provide the right care at the right time and right place. Health care homes use a team approach that gives patients and caregivers access to health care services and support.

Currently, MDH has certified 361 clinics or 54 percent of all primary care clinics in Minnesota. To be certified, clinics meet a rigorous set of requirements related to their ability to provide care that is coordinated, patient-centered, and team-based. About 3.6 million Minnesotans receive care in clinics certified as health care homes.

"These findings show the value of focusing on care coordination and disease management within the broad context of a patient’s life and community,” said Minnesota Commissioner of Health Ed Ehlinger, M.D. "Taking this approach can help us achieve the goal of improving quality while also reducing costs.”

The University of Minnesota study of Health Care Homes is the second of two legislatively mandated reports. The initial report was released in February 2014.

Results
The report, which evaluates the health care home initiative from 2010 through 2014, analyzed Medicaid and Medicare claims data comparing the use and cost of services between certified health care home clinics and non-health care homes. Results include:

 

  • Medical costs for enrollees who could be attributed to a health care home clinic were 9 percent less than enrollees who did not have a health care home as their primary care clinic.
  • Health care homes cost 12 percent less for Medicaid, 3 percent less for Dual Eligible enrollees, but were cost neutral for Medicare enrollees.
  • Health care homes were less expensive in four categories of healthcare spending: inpatient hospital admissions, hospital outpatient visits, skilled nursing facilities, and pharmacy.
  • Racial disparities were significantly smaller for Medicaid, Medicare, and Dual Eligible beneficiaries served by health care homes versus non- health care homes for most measures, with the exception of African American-White differences in Medicare, which tended to be slightly larger in health care homes.
  • On a broad range of clinical quality measures, HCH clinics outperform non- health care homes clinics.

 

The University of Minnesota relied on analysis of claims data from the Medicaid and Medicare programs, analysis of data from the Statewide Quality Reporting and Measurement System (SQRMS) collected by Minnesota Community Measurement, interviews with key stakeholders and certified Health Care Homes to assess the effect of the health care homes program on access, cost, quality, and patient experience and the transformation of clinics to being a health care home.

Next Steps
To gain a deeper understanding of health care homes and their context, members of the University of Minnesota team are studying risk adjustment for quality measurement and are continuing to study the correlates of effective inter-professional care teams.

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Content from UMN Health Sciences news release: http://www.health.umn.edu/news-releases/u-m-evaluation-finds-health-care-homes-saved-1-billion-over-5-year-period

For more than 60 years, the University of Minnesota School of Public Health has been among the top accredited schools of public health in the nation. With a mission focused on research, teaching, and service, the school attracts nearly $100 million in sponsored research each year, has more than 100 faculty members and more than 1,300 students, and is engaged in community outreach activities locally, nationally and in dozens of countries worldwide. For more information, visit www.sph.umn.edu.

The State of Minnesota’s Health Care Home (HCH) initiative is a joint initiative of the Minnesota Department of Health (MDH) and the Minnesota Department of Human Services (DHS), as directed by the Minnesota State Legislature. This initiative contributes to improving health care and population health in the State of Minnesota by implementing a Health Care Home practice model in health care clinics statewide.

As part of the HCH initiative’s enabling legislation, the State Legislature also directed MDH and DHS to provide comprehensive evaluations of the Health Care Home care delivery model to the legislature three and five years after implementation. Following this direction, this report provides a preliminary evaluation of the State of Minnesota’s Health Care Home initiative three years after implementation.


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