Program shows reduced use of emergency medical and hospital services
TACOMA, Wash. (Nov. 8, 2018) – Northwest Physicians Network (NPN), a part of DaVita Medical Group, which is a division of DaVita Inc. (NYSE: DVA), recently launched a collaborative program with various medical and community service groups in Pierce County, Washington that has led to a significant reduction in emergency services such as 911 calls, ambulance transports and hospital admissions.
Each year, thousands of individiuals in Pierce county call 911 to request emergency medical services for a variety of complex medical and social issues such as heart disease, diabetes, chronic obstructive pulmonary disease (COPD), Alzheimer’s disease, dementia, hypertension, chronic kidney disease (CKD), end-stage renal disease (ESRD), substance abuse and hip related emergencies. Some of these calls are emergency situations with immediate needs. Others, however, may be appropriately handled in a clinic or physicians office. For example, the Snohomish County fire district estimated that they responded to 10,000 non-emergency calls in 2015.
“Unfortunately, more often than not, these patients’ needs far extend the basic services provided by emergency service personnel,” said Bill Barber, battalion chief at West Pierce Fire and Rescue. “As a result, our resources are overburdened and the patient is stuck in a seemingly endless cycle of 911 calls and hospital visits because their health isn’t actually improving.”
In order to address this issue and help reduce the burden of potentially unnecessary emergency medical services, in 2014 NPN joined forces with six fire districts in Pierce County including West, East, Central, Gig Harbor and Graham, and various other local medical and community groups, to pilot a collaborative program in which the fire districts referred patients who call 911 more than twice in two months and more than five times in five months to NPN. NPN then refers the patient to case management services that are connected to their primary care, behavioral health provider or payor group. In some cases, NPN will work with community members to bring together a wellness team that meets with the patient to form a plan on how best to address their specific mental, medical or substance abuse issues.
“The success of this program is directly related to the relationships that we’ve formed in our community,” said Melissa Haney, community partnership and behavioral integration manager for NPN. “This program allowed health care and social services professionals, who may have never worked together before, to join forces in order to provide care that addresses the whole patient.”
Since the inception of the program in 2014, the collaborative has coordinated approximately 750 referrals to health systems and community resources. In addition, the collaboration has brought together 28 community partners that meet monthly to better understand which community services are available and work together to address barriers and change outcomes for patients.
NPN worked with Qualis Health, a population health care consulting organization, through their quality improvement organizations (QIO) program which is led by Centers for Medicare & Medicaid Services (CMS) and is one of the largest federal programs dedicated to improving health quality at the local level. In a subsequent report, Qualis Health tracked 184 patients who were referred within the first two years of the program, had Medicare insurance and were alive at least 12 months post-referral, and found that among these patients the following reductions occurred:
- Emergency calls were reduced by 44 percent
- Emergency transports were reduced by 47 percent
- Emergency department visits were reduced by 36 percent
- Hospital admissions were reduced by 43 percent
- Observational hospital stays were reduced by 31 percent
According to Qualis Health, the total reduction represents 990 fewer emergency medical services calls and 548 fewer ambulance transports. Qualis Health noted an improvement in patients’ health, as more than half of the patients experienced improved outcomes.
“The outcomes we unearthed were incredible,” said Meredith Agen, assistant vice president of health care analytics at Qualis Health. “The team measured changes for five key metrics over a 12-month period prior to intervention and 12-months post services; the outcomes we found represented a significant volume reduction for a small set of patients.”
The outcomes that Qualis Health discovered also translate into potential cost savings for both the patient and the emergency medical service personnel. Factoring in the cost per emergency department visit and admission, Qualis Health estimates a savings of $7.38 million for just these 184 Medicare patients on hospital visits alone. Statewide, there are more than 880,000 Medicare patients. Among those, there are an estimated 34,703 high-utilizers that represent more than four out of every 10 patients.
About DaVita Medical Group
DaVita Medical Group is a division of DaVita Inc., a Fortune 500® company, that operates and manages medical groups and affiliated physician networks in California, Colorado, Florida, Nevada, New Mexico and Washington. A leading independent medical group in America, DaVita Medical Group has over two decades of experience providing coordinated, outcomes-based medical care in a cost-effective manner. DaVita Medical Group’s teammates, employed clinicians and affiliated clinicians provided care for approximately 1.7 million patients. For more information, please visit DaVitaMedicalGroup.com.
About DaVita Inc.
DaVita Inc., a Fortune 500® company, is the parent company of DaVita Kidney Care and DaVita Medical Group. DaVita Kidney Care is a leading provider of kidney care in the United States, delivering dialysis services to patients with chronic kidney failure and end stage renal disease. As of June 30, 2018, DaVita Kidney Care operated or provided administrative services at 2,580 outpatient dialysis centers located in the United States serving approximately 201,000 patients. The company also operated 253 outpatient dialysis centers located in 10 countries outside the United States. DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Colorado, Florida, Nevada, New Mexico and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. DaVita Medical Group’s teammates, employed clinicians and affiliated clinicians provided care for approximately 1.7 million patients. For more information, please visit DaVita.com/About.