Developing an IDS-based disease-management program for the frail elderly
Baseman, S.; Truxell, R.
Healthcare Financial Management Journal of the Healthcare Financial Management Association 54(2): 33-36
2000
ISSN/ISBN: 0735-0732 PMID: 10947412 Document Number: 516895
IDSs that own a health plan or enter a full-risk-sharing contract with a payer are in an position to benefit from developing disease-management programs that reduce acute care admissions. Full-risk assumption allows an IDS to realize cost savings due to more cost-effective care management that offset revenue lost due to reduced acute care services. Crozer-Keystone Health System (CKHS) in Delaware County, Pennsylvania, implemented a disease-management program for frail elderly enrollees in its Medicare + Choice plan, MedCare Plus. Projected first-year savings were estimated at about $619,000 over 1,200 member months. First-year results showed a 36 percent reduction in acute care admissions, with savings of $242,749 over 613 member months. The difference between actual results and projected savings was attributed to social and other factors not accounted for in the cost-benefit analysis. Still, lost revenues from acute care admissions were more than offset by the savings realized.