A Systematic Review of Intensive Outpatient Care Programs for High-Need, High-Cost Patients

Rebecca K. Delaney
Brittany Sisco-Taylor
Angela Fagerlin
Peter Weir
Elissa M. Ozanne
Peer-Reviewed Article
October 2020

Intensive outpatient care programs (IOCPs) — innovative clinical care interventions that provide patient-centered care through the use of multidisciplinary care teams — are being increasingly developed to care for individuals with complex needs, with the goals of reducing costs and utilization while improving patient outcomes. IOCPs target high-risk patients, and they are unique from case management or care coordination because multiple providers address patient needs in a dedicated clinic. Another distinctive feature is that IOCPs use alternative payment models as opposed to a fee-for-service model to cover unique services and resources for their patient populations. This systematic review examines the effectiveness of IOCPs on a variety of outcomes.

Across multiple studies, patients in IOCPs experienced lower rates of hospital admissions, readmissions, emergency department visits, length of hospital stays, and primary care and specialty visits compared to control groups. A subset of the studies in the review reported on the cost impact of the IOCP, with two reporting cost reductions and one reporting cost-neutrality. Some studies focused on health-related and patient-reported outcomes, and reported outcomes such as improved blood pressure range and A1C levels in patients with diabetes, as well as improved ratings of anxiety, depression, and quality of life. Overall, IOCPs show promise for improving care of high-need, high-cost patients.


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