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.
Project Title: "Sanford One Care: transforming primary care for the 21st Century”
Geographic Reach: Iowa, Minnesota, North Dakota, South Dakota
Funding Amount: $12,142,606
Estimated 3-Year Savings: $14,135,429
Summary: Sanford Health received an award to develop an innovative and sustainable primary care delivery model for patients with chronic disease through workforce development, enhanced technology and the integration of behavioral health. Primary care clinics in South Dakota, North Dakota and Minnesota will be equipped to provide proactive outcomes-based care for patients with chronic disease and help patients manage their own healing and healthy behaviors. This new model of care will result in improved outcomes, better patient experience and reduced patient costs. Over a three-year period, Sanford Health’s program will train an estimated 425 health care providers in enhanced clinical and patient engagement skills.
TRUSTEES OF DARTMOUTH COLLEGE
Project Title: “Engaging patients through shared decision making: using patient and family activators to meet the triple aim”
Geographic Reach: California, Colorado, Idaho, Iowa, Maine, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Oregon, Texas, Utah, Vermont, Washington
Funding Amount: $26,172,439
Estimated 3-Year Savings: $63,798,577
Summary: The High Value Healthcare Collaborative (HVHC) received an award led by The Trustees of Dartmouth College to implement patient engagement and shared decision making processes and tools across its 15 member organizations for patients considering hip, knee, or spine surgery and complex patients with diabetes or congestive heart failure. The program will hire and train 48 health coaches across the 15 member organizations to engage patients and their families in their health care and health decisions.
High Value Healthcare Collaborative (HVHC) is implementing a bundle of services related to the care of sepsis patients across 13 health care systems around the country. The overall goal of this project is to utilize process improvement strategies to implement specific services at 3- and 6-hours post diagnosis as defined by the Surviving Sepsis Campaign (SSC) and National Quality Forum (NQF) guidelines for the care of severe sepsis or septic shock. Over three years, this intervention aims to improve optimal adherence to sepsis bundled care by 5%, reduce the burden of chronic morbidity from sepsis-associated chronic organ dysfunction, and achieve a 5% relative rate reduction in the number of patients with sepsis requiring long-term acute care or sub-acute nursing care after an incident episode of severe sepsis.
UNIVERSITY OF IOWA
Project Title: "Transitional care teams to improve quality and reduce costs for rural patients with complex illness"
Geographic Reach: Iowa
Funding Amount: $7,662,278
Estimated 3-Year Savings: $12,500,000
Summary: The University of Iowa, in partnership with 10 Critical Access Hospitals(CAHs), is improving care coordination and communication with practitioners in nine rural Iowa counties. The program serves adults in these counties and selected contiguous catchment areas in which a CAH serves large numbers of patients. Adults are served without regard to whether they are Medicare, Medicaid, Medicare/Medicaid dual-eligible beneficiaries privately insured or uninsured. The aim is to assist adults with complex illness being discharged from the University of Iowa Hospitals & Clinics from psychiatric and internal medicine departments. Their complex issues may include psychiatric disorders, heart disease, kidney disease, endocrine and gastrointestinal disorders, pulmonary and geriatric issues. The program coordinates care through teams comprised of nurses, social workers, and pharmacists along with specialty physicians (including psychiatrists) using a care coordination protocol that informs, facilitates and ensures post discharge care and incorporating telehealth and web-based personal health records. The program is based on the University of Iowa's significant past experience in care coordination and creating telehealth care teams for patients with diabetes, chronic obstructive pulmonary disease, and heart failure. It will increase access to services and specialty care, improve care transitions and care coordination, and decrease avoidable hospital readmissions of complex patients in rural counties in Iowa.
Over a three-year period, the University of Iowa's program will train an estimated 22 workers and will create an estimated 28 jobs. The new hires will include 10 community care coordinators, two project managers, a program secretary, an outcomes analyst, a qualitative analyst, a database manager, nurse team leaders, social workers, and an informatics director.