NEW DIRECTIONSAN INTENSIVE CASE MANAGEMENT PROGRAM

Frequent Users of Healthcare Initiative MeetingSeptember 2006

DATA COLLECTED

At enrollment, 6 months, 18 months:

FUI Demographics & Functional Status FUI assessment tools (Lehman Qof L,

SF12, Stages of Change)

DATA COLLECTED (cont’d)

For Prior Year, Yr. 1, Yr. 2, and Yr. 3:

# of ED visits, admissions, hospital days, clinic visits Direct costs* for ED, inpatient, outpatient care # of ambulance rides Mental health contacts DADS contacts

* Direct Costs = Costs for direct care only, no overhead, administrative, or indirect costs

DATA COLLECTED (cont’d)

Staff contact log Disenrollment log

METHODOLOGY

Compare Prior Yr. to Yr. 1, Yr. 2, & Yr. 3

Eventually compare a control group of 40 clients to the case managed group of clients

ANALYSIS #1

COMPARE

Prior Year vs. Yr 1, Yr. 2, and Yr. 3

Percent change in visits*/admits/hospital days Number of visits/admits/hospital days Percent change in direct costs of ED/inpt./outpt. care Direct costs in dollars of ED/inpt./outpt. care

* Visits = ED, Outpt, MH, DADS visits

ANALYSIS #2

Separate clients by those that were successful vs. unsuccessful

Successful = ED visits decreased below the threshold for program (i.e. less than 8 visits / year)

Unsuccessful = ED visits continue with more than 8 ED visits / year

Complete analysis #1 for both groups

RESULTS – Hospital B

46 Clients followed for 2 years 85% Success Rate (39 out of 46 reduced ED visits to < 8) Successful Clients (39)

ED visits decreased 80% in Yr. 2 Hospital & ED Costs decreased (-$98,234) in Yr. 2 39 clients = 40% of total case load For total case load of current program - costs would

decrease by ~$245,500 for all clients

RESULTS – Hospital B (cont’d)

Unsuccessful Clients (7) ED visits increased in Yr. 1 by 18%, decreased only

3% in Yr.2 ED costs increased in Yr. 1 (52%) and Yr. 2 (65%) Hospital and ED costs increased in Yr. 1 (+$39,000)

and Yr. 2 (+$68,700) In Yr. 2 outpatient costs increased more for these 7

clients than all 39 successful clients(~$57,000 vs. $23,500)

RESULTS Successful Clients (85%) – Hospital B Change in ED Utilization & Costs – Yr 1 & Yr 2

Changes in:1st Yr. vs Baseline Yr.

N = 39

2nd Yr. vs Baseline Yr.N = 39

% ED Visits 41 % 80 %

# ED Visits 130 217

in ED Visits 318 188 318 64

% ED Costs 37 % 65 %

Actual ED Costs $26,667 $44,918

In ED Costs $103,150 $64,710 $103,150 $35,720

RESULTS Unsuccessful Clients (15%) – Hospital B Change in ED Utilization & Costs – Yr 1 & Yr 2

Changes in:1st Yr. vs Baseline Yr.

N = 7

2nd Yr. vs Baseline Yr.N = 7

% ED Visits 18 % 3 %

# ED Visits 18 3

in ED Visits 102 120 102 99

% ED Costs 52 % 65 %

Actual ED Costs $14,022 $17,668

In ED Costs $27,196 $41,218 $27,196 $44,864

RESULTS Successful Clients (85%) – Hospital B Change in Hosp. & Outpt. Costs --Yr 1 & Yr 2

Changes in:1st Yr. vs Baseline Yr.

N = 39

2nd Yr. vs Baseline Yr.N = 39

Inpatient Costs $161,545 $22,447

in Inpt. Costs $185,970 $347,515 $185,970 $163,523

Outpatient Costs $38,253 $23,459

In Outpt. Costs $87,997 $126,250 $87,997 111,456

RESULTS Unsuccessful Clients (15%) – Hospital B Change in Hosp. & Outpt. Costs --Yr 1 & Yr 2

Changes in:1st Yr. vs Baseline Yr.

N = 7

2nd Yr. vs Baseline Yr.N = 7

Inpatient Costs $82,882 $51,057

In Inpt. Costs $125,049 $207,931 $125,049 $176,106

Outpatient Costs $25,825 $56,951

In Outpt. Costs $37,169 $63,021 $37,169 94,120