Study: New Care Management Approach Reduced Hospitalizations 12% in St. Louis

Washington University School of Medicine in St. Louis reduced hospitalizations by 12 percent and monthly Medicare spending by $217 per enrollee after redesigning its care management program, according to a study in Health Affairs.

Washington University School of Medicine was one of the original 15 participants in the Medicare Coordinated Care Demonstration. Initially, the school did not reduce hospitalizations or Medicare spending, but instead increased total Medicare spending by 12 percent. The university then changed its care management approach.




Instead of conducting care management for most patients via telephone from a remote site in California, the organization spoke with patients through frequent phone and occasional in-person contact from local care managers in St. Louis, focusing particularly on patients with the greatest risk of hospitalization. The university also provided stronger hospital transition planning and medication reconciliation. The resulting savings more than offset the program's monthly $151 care management fee.

The findings confirm the overall demonstration's findings that programs with more in-person contacts are more likely than others to build trusting relationships with patients and providers, improve patient adherence to care plans and address additional needs and barriers.

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