How hospitals can use the intensive outpatient care unit to improve care, lower costs for resource-intensive patients

As more hospitals and health systems begin integrating value-based care models into their care delivery, many are seeing improved quality and lower costs as a result of intensive outpatient care programs, according to Health Affairs.

This is a particularly promising approach when providing healthcare for patients with multiple complex and chronic diseases, who account for a significant proportion of total healthcare expenditures.

In the IOCP model, care coordinators form relationships with patients and work closely with them until their health is stabilized, according to the report. The patients selected for the model are identified through predictive risk modeling and retrospective utilization reviews, as well as a clinical review by a physician or nurse.

The IOCP model includes the following seven core elements, according to Health Affairs:

1. Trained care coordinators — such as nurses or social workers — lead teams that include community health workers and medical assistants
2. An in-person visit with the care coordinator and patient within one month of enrollment
3. Standardized longitudinal assessments on physical function, mental well-being and patient engagement in his or her healthcare
4. Monthly communication between the care coordinator and the patient
5. The development of a "Shared Action Plan," which includes the patient's goals at the center
6. Supported transitions to services such as home health, behavioral health and transportation
7. 24/7 access to services and communication with the care coordinator within one business day

Data from IOCP models employed in commercial populations show a nearly 20 percent reduction in costs among patients with multiple complex chronic diseases. Additionally, findings from a Milliman and PBGH analysis show high-risk Medicare beneficiaries treated by IOCP practices experienced a decrease in hospital admissions, inpatient days and emergency room visits, according to Health Affairs.

Medicare beneficiaries receiving care from IOCP practices also experienced numerous health status improvements, such as patient activation, mental health and physical functioning.