Notes and Disclaimers:
- Projects shown may also have operated in other states. (see Geographic Reach)
- Descriptions and project data (e.g. gross savings estimates, population served, etc.) are 3 year estimates provided by each organization and are based on budget submissions required by the Health Care Innovation Awards application process.
- While all projects were expected to produce cost savings beyond the 3 year grant award, some may not achieve net cost savings until after the initial 3-year period due to start-up-costs, change in care patterns and intervention effect on health status.
CHRISTUS ST. MICHAEL HEALTH SYSTEM
Project Title: "Reducing readmissions from nursing home facilities with the Integrated Nurse Training and Mobile Device Harm Reduction Program"
Geographic Reach: Arkansas, Texas
Funding Amount: $1,600,322
Estimated 3-Year Savings: $3,536,440
Summary: CHRISTUS St. Michael Health System, in partnership with the Community Long-Term Care Facility Partnership Group and University of the Incarnate Word, received an award to implement the Integrated Nurse Training and Mobile Device Harm Reduction Program (INTM). The INTM will train nurses to recognize early warning signs of congestive heart failure (CHF) and sepsis in Medicare beneficiaries in nursing home facilities and patients in hospitals who are vulnerable to certain preventable conditions. The project team developed an educational program that includes customized, clinical decision support mobile device training, and interactive didactic sessions. The training, in combination with computerized clinical decision support systems that guide nurses through evidence-based protocols once symptoms are detected and mobile devices loaded with clinical support system software, is anticipated to result in a 20% reduction in readmissions from long term care facilities for CHF and sepsis and fewer failure-to-rescue situations for those patients who are admitted to the hospital.
DEVELOPMENTAL DISABILITIES HEALTH SERVICES
Project Title: “Expanding and testing a Nurse Practitioner-led health home model for individuals with developmental disabilities”
Geographic Reach: Arkansas, New Jersey, New York
Funding Amount: $3,701,528
Estimated 3- Year Savings: $5,374,080
Summary: Developmental Disabilities Health Services received an award to test a developmental disabilities health home model using care management/primary care teams of nurse practitioners and MDs to improve the health and care of persons with developmental disabilities in important clinical areas. This health home model serves individuals with intellectual and developmental disabilities who receive Medicaid and/or Medicare benefits in New Jersey, the Bronx, and Little Rock, Arkansas, and are eligible for services in each state's Home- and Community-Based Services waiver program, as well as individuals who are commercially insured and uninsured. All of the patients are considered high-risk and many have co-morbidities. By integrating care using nurse practitioners as care coordinators and health care providers, the health homes are improving primary care, mental health care, basic neurological care, and seizure management for these beneficiaries, resulting in reduced emergency room visits and lower out-of-home placement and institutionalization. Over a three-year period, Developmental Disabilities Health Services will retrain and deploy 20 individuals to provide and coordinate primary care and mental health services in health homes for persons with developmental disabilities.
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Project Title: “Cost-effective delivery of enhanced home caregiver training”
Geographic Reach: Arkansas, California, Hawaii, Texas
Funding Amount: $3,615,818
Estimated 3-Year Savings: $1,286,251
Summary: The University of Arkansas for Medical Sciences received an award for enhanced training of both family caregivers and the direct-care workforce in order to improve care for elderly patients requiring long-term care services, including Medicare beneficiaries qualifying for home healthcare services and Medicaid beneficiaries who receive homemaker and personal care assistant services. Inadequate training of the direct care worker has been shown to have a direct impact on the quality of care to the elderly. By enhancing the training of the direct-care workforce, the increasingly complex care needs of the older adult can be better managed in the home, leading to fewer avoidable hospital admissions and readmissions, better preventive care, better compliance with care, and avoidance of unnecessary institutional care. The investments made by this grant are expected to generate cost savings beyond the three year grant period. Over a three-year period, The University of Arkansas for Medical Sciences’ program will train an estimated 2,100 workers and will create an estimated four jobs. The new workforce will include a project manager, a nurse educators and an administrative assistant. Additionally, this program will train home care givers in rural areas using distance education. Through tuition and textbook support in the form of microcredit loans, this program will increase the number of certified caregivers providing direct care to elderly adults.
UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
Project Title: "Project SAFEMED"
Geographic Reach: Arkansas, Mississippi, Tennessee
Funding Amount: $2,977,865
Estimated 3-Year Savings: $3,160,844
Summary: The University of Tennessee Health Science Center, in partnership with Methodist LeBonheur Healthcare's Methodist North Hospital and Methodist South Hospital and community partners received an award to improve care transitions with an emphasis on medication management among high repeat utilizing patients in the northwest and southwest sections of Memphis, TN. The program will serve vulnerable adults (20-64) and seniors 65+ insured by Medicaid and/or Medicare who have multiple chronic diseases, including hypertension, diabetes, coronary artery disease, congestive heart failure, and chronic lung disease with presence of polypharmacy or high risk medications. Through multidisciplinary teams encompassing pharmacy, nursing, and social work based in outpatient centers, the program will enhance discharge planning, improve post-discharge outreach and follow-up, increase access to community based services and coordinate care across providers and settings. In addition, pharmacy technicians and licensed practical nurses will serve as outreach workers engaging patients through home visits, intense phone follow up, and group based support sessions. This approach will improve medication adherence to safe and effective medication regimens, overall chronic disease self-management, health services utilization patterns, and patient experience of care. Over a three-year period, the University of Tennessee Health Science Center's program will develop 5 new roles for direct care staff and create 11 jobs in the healthcare field.