A community-based palliative care program, made up of nurses and social workers, reduced medical costs, intensive care unit (ICU) admissions, hospital admissions, and days spent in the hospital for Medicare Advantage members with serious illness.
Population health models, which proactively identify patients, deploy interdisciplinary teams to manage care, and evaluate patient populations through data analysis, may result in more compassionate, affordable, and sustainable care. This study evaluates a community-based palliative care program with a population health approach to determine potential clinical and cost benefits. Nurses and social workers staffed by Mount Carmel Hospice and Palliative Care in Columbus, Ohio provided clinical care and coordination in the home. The program partnered with Turn-Key Health to use data analytics to identify the patient population by level of need — low, medium, and high — and tailored interventions accordingly.
Medicare Advantage plan members who received community-based palliative care had significantly lower costs and critical care utilization compared to a matched control group that received standard health plan case management. There was a 20 percent reduction in total medical costs, a 38 percent reduction in ICU admissions, a 33 percent reduction in hospital admissions, and a 12 percent reduction in hospital days.
Mount Carmel’s structured nurse and social work model, paired with Turn-Key’s predictive analytics, helped target resources to high-need populations and reduce inappropriate health care utilization and costs. The partnership evaluated in this article can help inform health plans and providers seeking to implement a population health model for their community-based palliative care program.