Notes and Disclaimers:
- Projects shown may have also operated in other states (see the 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.
HEALTH RESOURCES IN ACTION
Project Title: “New England asthma innovations collaborative”
Geographic Reach: Connecticut, Massachusetts, Rhode Island, Vermont
Funding Amount: $4,040,657
Estimated 3-Year Savings: $4,100,000
The "New England Asthma Innovation Collaborative” (NEAIC) is a multi-state, multi-sector partnership convened by the Asthma Regional Council of New England (ARC), a program of Health Resources in Action (HRiA), that includes health care providers, payers, and policy makers aimed at creating an innovative Asthma Marketplace in New England that will increase the supply and demand for high-quality, cost-effective health care services delivered to Medicaid children with severe asthma. Our goal is to create a sustainable infrastructure that robustly delivers evidence-based cost-effective asthma care to New England children with severe disease, and creates viable Medicaid reimbursement mechanisms to support these programs over the long-term. The targeted population is high-cost Medicaid and CHIP pediatric patients (2 – 17 years), with a focus on those with uncontrolled symptoms that have a history of using expensive urgent care. NEAIC includes following components:
1. Workforce development: NEAIC will: a) sponsor Asthma Training to increase the number of well qualified cost-effective providers, including certified asthma educators (AE-Cs) and community health works (CHWs) with a specialty in asthma; and b) explore CHW asthma credentialing program that payers and provider practices across NE have requested and can benefit from. All of this will contribute to higher quality and culturally competent care, and we believe will help to support innovative Medicaid reimbursement as a result of demonstrated cost-effective outcomes.
2. Rapid service delivery expansion for over 1300 high-risk children with asthma in Connecticut, Rhode Island, Massachusetts, and Vermont. NEAIC employs the following components of care: 1) Asthma self-management education 2) Home environmental assessment with the provision of minor-to-moderate environmental intervention supplies to reduce asthma triggers; and 3) Use of non-physician providers shown to be cost-effective deliverers of this level of care, particularly community health workers (CHWs) and certified asthma educators (AE-Cs).
3. Committed Medicaid payers in several New England states will work to sustain these programs by piloting reimbursement methodologies with the service providers, should the service model results demonstrate the goals of delivering better health, improving care and lowering costs..
4. A Payer and Provider Learning Community across all six New England states to rapidly disseminate demonstrated improvements to the quality and cost of asthma care, share viable reimbursement systems developed, successfully incorporate CHWs into the asthma care team, and disseminate best practices. The Learning Community builds on ARC’s existing networks and partnerships across the region, and is meant to increase awareness about these successful models with the goal of broader adoption across New England.
NEAIC’s components build in continuous quality improvement measures through rigorous data collection/analysis, strong partnerships, and commitments from interested payers and policy makers. The establishment and promotion of CHWs as strong health care delivery partners addressing environmental conditions as part and parcel of the disease management program, with reimbursement by payers, make this an innovative model for broad dissemination and potential for replication across the nation.
UNIVERSITY OF RHODE ISLAND
Project Title: "Living Rite-A Disruptive Solution for Management of Chronic Care Disease (a focus on adults with disabilities: intellectual and developmental diagnoses and dementia patients with 2 or more chronic conditions)"
Geographic Reach: Rhode Island
Funding Amount: $13,955,411
Estimated 3-Year Savings: $15,526,726
Summary: The University of Rhode Island’s Living Rite Innovations project is delivering holistic coordinated care through the project’s two Living Rite Centers. The Centers, with their three part goal of (1) Health care: designed to improve care for adults with intellectual and developmental disabilities and /or Alzheimer’s disease and are dual eligible beneficiaries of Medicare and Medicaid. The Centers provide comprehensive chronic care management in order to coordinate services between multiple community providers, improve health and decrease unnecessary hospitalizations and ER visits. The Centers’ interdisciplinary team includes physicians, nurse-practitioners, RNs, pharmacists, OTs, PTs, and dieticians. (2) Well-being: Through the Centers’ healthy behavior change models, clients are being trained how to best manage their chronic diseases.(3) Employment: Using the Employment First philosophy, the Centers provide career development, benefits planning and job placement services to assist clients in attaining jobs. Furthermore, Living Rite project plans to help people with disabilities outside the centers to become employed. Lastly, the creation of the URI-Intra-Professional Health Education Center will certify various health professional students as qualified interdisciplinary team members.
WOMEN & INFANTS HOSPITAL OF RHODE ISLAND
Project Title: “Partnering with parents, the medical home and community provider to improve transition services for high-risk preterm infants in Rhode Island”
Geographic Reach: Rhode Island
Funding Amount: $3,261,494
Estimated 3-Year Savings: $3,700,000
Summary: Women and Infants Hospital of Rhode Island received an award to improve services for approximately 2400 families in Rhode Island who have pre-term or high-risk full term babies with a Neonatal Intensive Care Unit (NICU) admission of 5 or more days. The Partnering with Parents intervention has hired, trained and deployed Early-Moderate Preterm, Late Preterm, and high-risk full term family care teams to offer education and support to parents during the transition from the NICU to home, and monitor infants’ growth and development. The program also supports primary care providers who help provide care for this at-risk population and has partnered with home nursing agencies throughout the state to coordinate infants’ care post discharge. The results are expected to be reduced emergency room visits, fewer hospital readmissions, and decreased neonatal morbidity. This approach is expected to lower costs while improving health and health care for pre-term and high-risk full term babies in Rhode Island with estimated savings of approximately $3.7 million. Over the three-year period, Women & Infants Hospital of Rhode Island’s program will train an estimated 120 health care workers and early intervention providers, while creating an estimated 12 new jobs. The Partnering with Parents program is training and deploying these workers as part of Family Care Teams to offer education and support and monitor infants’ growth and development.