VOL. 132 | NO. 155 | Monday, August 7, 2017
Regional One Launches Data-Driven Study to Cut Costs
By Andy Meek
Regional One Health has teamed up with a New Jersey-based nonprofit for a three-year project aimed at identifying and addressing the reasons why some patients become what the organizations refer to as “high utilizers” of hospital services.
Regional One’s partnership with the Camden Coalition will, according to a hospital spokesman, allow for a deep dive into the hospital’s data to help it better understand patients and trends related to circumstances that create their care needs. It’s about learning the underlying reasons why people become patients and what the hospital can do to reduce or eliminate some of those reasons.
The project, funded in part by the Assisi Foundation, is estimated to cost about $4 million over the three-year period. Part of those funds will be used to create a plan that helps reduce costs for the hospital system and improve the health of the patient population. Regional One has determined that if it achieves the financial outcomes it’s working toward during the three years of the program, at year four the system would be able to sustain and fund the program itself.
Susan Cooper, chief integration officer and senior vice president of ambulatory services for Regional One, said the first six months will be structured around understanding data and the patient population, as well as the influences that lead people to seek care at Regional One. After that comes hiring a program manager, and – once they are confident in the data – choosing a care model that’s more applicable “to a subset of those high utilizers.”
“If we can form trusting relationships and help people create a vision of what could be, and surround them with better resources in the community, we should see at the end of implementation fewer emergency room visits, fewer readmissions to the hospital within the first 30 days of discharge, and an increase of primary care visits,” Cooper said.
"When you look at the patient population that we serve, there are a number of people who utilize high-cost services, like the emergency department or inpatient admissions, more frequently than others,” she said. “A hospital or emergency department isn’t the best place to take care of routine or chronic conditions.”
The assessment phase of the project is already underway. Regional One Health has hosted a few gatherings with Camden representatives, one with community organizers and another with Regional One staff.
The Memphis hospital’s relationship with Camden started back in 2002. Camden Coalition founder Dr. Jeff Brenner did some research and found that 20 percent of patients in his Camden, New Jersey, hospital accounted for 90 percent of costs.
His first 36 patients averaged 62 hospital and emergency-room visits per month before the data-driven intervention, according to Regional One. That dropped, however, to 37 visits post-intervention. And the total hospital bill fell to a little more than $500,000 from a monthly average of $1.2 million.
Closer to home, there were 1,023 self-pay, TennCare and unmanaged Medicare patients who visited Regional One Health’s emergency room in fiscal year 2015. Those patients were responsible for $81 million in charges.
With Camden Coalition’s help, Regional One’s early estimates suggest it can save more than $1 million by targeting those so-called high utilizers.
The key, of course, is how.
Regional One says Camden Coalition starts fresh when it comes in to a city like Memphis, to figure out what model is best for a particular area. The Memphis hospital says the next steps include data analysis and reaching a deeper understanding of its patient population and of the community.
“One of our core principles is, we’re not here to sell a model,” said Camden Coalition senior director of education and curriculum Lauran Hardin. “We’re here to share resources that will help.”