Strategy Of Targeting Hard-To-Treat Patients Held Incredible Promise For Cutting Costs. Then Came The Data.
The method of finding the most expensive, hard-to-treat patients and better coordinating their care was touted as a popular idea for containing health care costs. A new study offers a harsh reality check on the benefits of such a strategy though. The surprising lack of results offers a cautionary tale about how difficult it is to improve patients’ care and reduce costs.
The Associated Press:
Program Meant To Curb Repeat Hospital Stays Fails Big Test
Researchers thought they had a way to keep hard-to-treat patients from constantly returning to the hospital and racking up big medical bills. Health workers visited homes, went along to doctor appointments, made sure medicines were available and tackled social problems including homelessness, addiction and mental health issues. Readmissions seemed to drop. The program looked so promising that the federal government and the MacArthur Foundation gave big bucks to expand it beyond Camden, New Jersey, where it started. But a more robust study released Wednesday revealed it was a stunning failure on its main goal: Readmission rates did decline, but by the same amount as for a comparison group of similar patients not in the costly program. (1/8)
The New York Times:
These Patients Are Hard To Treat
But a new study, published Wednesday in the New England Journal of Medicine, showed that the Camden program did not result in fewer hospital readmissions in the six months after a patient left the hospital. While the program appeared to lower readmissions by nearly 40 percent, the same kind of patients who received regular care saw a nearly identical decline in hospital stays. (Abelson, 1/8)
The New York Times:
Deflating Results Of Major Study Point To Better Ways To Cut Health Care Waste
To try to avoid a repeat hospitalization, the program provided an unusually large amount of care to very sick patients after they left the hospital, including from registered nurses, social workers, licensed practical nurses, community health workers and health coaches. In the three months after a hospital stay, an average patient in the program received 7.6 home visits and 8.8 phone calls from staff. In addition, program staff went along on patients’ visits to physicians, which averaged 2.5 per person. (Frakt, 1/8)
Kaiser Health News:
Reduce Health Costs By Nurturing The Sickest? A Much-Touted Idea Disappoints
The results are a blow to Dr. Jeffrey Brenner and the Camden Coalition of Healthcare Providers, the organization he founded nearly 20 years ago. “It’s my life’s work. So, of course, you’re upset and sad,” said Brenner, who now does similar work with health insurance giant UnitedHealthcare. The model of care, pioneered in part by Brenner and profiled in a widely read 2011 article in The New Yorker, has inspired dozens of similar projects across the country and attracted millions in philanthropic funding. (Gorenstein and Walker, 1/8)
In other health care costs news, the price of having a baby and surprise medical bills —
CBS News:
Cost Of Having A Baby Hits $4,500 Out Of Pocket With Employer-Provided Insurance
The cost of giving birth in America has skyrocketed in recent years — even for women with employer health insurance. A major study looking at women with employer-provided health insurance found that the average new mom spent $4,500 out-of-pocket to give birth in 2015, the most recent year data are available. That's a 50% increase from 2007, when the typical new mom paid out just over $3,000 of her own money. It's also more than three times the rate of inflation over that time period. (Ivanova, 1/8)
The Hill:
Hoyer: Democratic Chairmen Trying To Bridge Divide On Surprise Medical Bills
House Majority Leader Steny Hoyer (D-Md.) said Wednesday that two Democratic committee chairmen are trying to work out their differences over a measure that would protect patients from surprise medical bills. A bipartisan group of lawmakers has been pushing for months to pass legislation protecting patients from getting massive bills when they go to the emergency room and one of their doctors happens to be outside their insurance network. (Sullivan, 1/8)
Kaiser Health News:
‘An Arm And A Leg’: Watch Your Back — And Your Wallet
In 2008, Cathryn Jakobson Ramin was an investigative journalist whose back was killing her.She was considering surgery but, after learning more about her options and the failure rate of surgery, instead spent six years researching what she now calls the “back pain industry.” She found that the most commonly prescribed treatments, including surgery, frequently do not work — and often leave people a lot worse off. (Weissmann, 1/9)
