How Changes In Washington University’s Medicare Coordinated Care Demonstration Pilot Ultimately Achieved Savings

• DOI: 10.1377/hlthaff.2011.0593
• Publication Date: 2012-06-05T06:44:05Z
• Authors: Deborah Peikes; Greg Peterson; Randall S. Brown; Sandy Graff; John P. Lynch
• Keywords: Aged, 80 and over; Missouri; Universities; Pilot Projects; Medicare; United States; Patient Care Management; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Cost Savings; Humans; Aged

As one of the initial fifteen participants in Medicare Coordinated Care Demonstration, Washington University School Medicine St. Louis was not able to demonstrate any reduction hospitalizations or spending for patients it served. In fact, program increased total by 12 percent. But after a redesign, results changed. The stopped conducting care management most its via telephone from remote site California and, instead, served all through frequent phone and occasional in-person contact local managers Louis. efforts were focused especially on deemed at greatest risk hospitalization, stronger hospital transition planning medication reconciliation provided, among other changes. After that point, reduced percent monthly $217 per enrollee—more than offsetting program's $151 fee. underscore findings overall Demonstration suggest programs with more contacts likely others build trusting relationships providers, improve patient adherence plans, address additional needs barriers entirely telephonic had been unable identify. also indicate can be effective focusing highest-risk patients, whom largest savings resulted.