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.
INNOVATIVE ONCOLOGY BUSINESS SOLUTIONS, INC.
Project Title: “Community oncology medical homes (COME HOME)”
Geographic Reach: Florida, Georgia, Maine, New Mexico, Ohio, Texas
Funding Amount: $19,757,338
Estimated 3-Year Savings: $33,514,877
Summary: Innovative Oncology Business Solutions, Inc., representing 7 community oncology practices across the United States received an award to implement and test a medical home model of care delivery for newly diagnosed or relapsed Medicare and Medicaid beneficiaries and commercially insured patients with one of the following seven cancer types: breast, lung, colon, pancreas, thyroid, melanoma and lymphoma. Cancer care is complicated, expensive, and often fragmented, leading to suboptimal outcomes, high cost, and patient dissatisfaction with care. Through comprehensive outpatient oncology care, including extended clinic hours, patient education, team care, medication management, and 24/7 practice access and inpatient care coordination, the medical home model will improve the timeliness and appropriateness of care, reduce unnecessary testing, and reduce avoidable emergency room visits and hospitalizations. Over a three-year period, Innovative Oncology Business Solutions will fill 115.6 new health care jobs, including positions for training specialists, data analysts, patient care coordinators, registered nurses, and licensed practical nurses, as well as for a finance manager and a compliance manager.
NATIONAL COUNCIL OF YOUNG MEN'S CHRISTIAN ASSOCIATIONS OF THE UNITED STATES OF AMERICA (YMCA OF THE USA)
Project Title: "Delivery on the promise of diabetes prevention programs"
Geographic Reach: Arizona, Delaware, Florida, Indiana, Minnesota, New York, Ohio, Texas
Funding Amount: $11,885,134
Estimated 3-Year Savings: $4,273,807
Summary: The National Council of Young Men's Christian Associations of the United States of America (Y-USA), in partnership with 17 local Ys currently delivering the YMCA’s Diabetes Prevention Program, the Diabetes Prevention and Control Alliance, and 7 other leading national non-profit organizations focused on health and medicine, is serving prediabetic Medicare beneficiaries in 17 communities across 8 states in the U.S. The intervention delivers community-based diabetes prevention through a nationally-recognized diabetes prevention lifestyle change program, coordinated and taught by trained YMCA Lifestyle Coaches. The goal is to prevent the progression of prediabetes to diabetes, which will improve health and decrease costs associated with complications of diabetes, hypercholesterolemia, and hypertension. The investments made by this grant are expected to generate cost savings beyond the three year grant period. Over a three-year period, Y-USA and its partners will train an estimated 1500 workers and create an estimated eight jobs. The new jobs will include communication specialists, a program manager, a grant administrator, a workforce development manager, data specialists, training specialists, and administrative coordinator.
THE NATIONAL HEALTH CARE FOR THE HOMELESS COUNCIL
Project Title: “Community health workers and HCH: a partnership to promote primary care”
Geographic Reach: California, Illinois, Massachusetts, Nebraska, New Hampshire, North Carolina, Ohio, Texas
Funding Amount: $2,681,877
Estimated 3-Year Savings: $1,500,000
Summary: The National Health Care for the Homeless Council is working with twelve communities across various regions in the U.S. to reduce the number of emergency department visits and lack of primary care services for over 500 homeless individuals. The intervention integrates community health workers into Federally Qualified Health Centers to conduct outreach and case coordination for transitioning this population from the emergency department to a health center, thus reducing unnecessary emergency department visits and improving quality of care for this population. Over the three-year period, National Health Care for the Homeless Council’s program will train an estimated 101 health care workers, while creating an estimated 17 new jobs and saving approximately $1.0 million.
THE RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL
Project Title: "Partners for Kids Expansion"
Geographic Reach: Ohio
Funding Amount: $13,160,092
Estimated 3-Year Savings: $51,714,650
Summary: The Research Institute at Nationwide Children's Hospital, in partnership with Akron Children’s Hospital and its integrated physician group, received an award to expand its Partners for Kids (PFK) program in Ohio, serving over 492,000 Medicaid children enrollees and 25,000 children with disabilities (the most costly pediatric population). PFK will enhance provider incentives and improve access for high risk rural and urban underserved populations through comprehensive medical home-based services and the rapid deployment of an expanded health care workforce focusing on behavioral health, complex care, and high risk pregnancy.
UNIVERSITY HOSPITALS OF CLEVELAND
Project Title: “Transforming pediatric ambulatory care: the physician extension team”
Organizations: University Hospitals (UH) Rainbow Babies and Children’s Hospital at UH Case Medical Center partnering with Ohio Medicaid, CareSource, WellCare, 4 community mental health agencies, Cuyahoga Community College, Cleveland Schools, Head Start, InstantCare, and HealthSpot.
Geographic Reach: Ohio
Funding Amount: $12,774,935
Estimated 3-Year Savings: $13,500,000
Summary: University Hospitals Rainbow Babies & Children’s Hospital received funding to create a pediatric program to improve care, overall health and lower costs for children in Northeast Ohio. Rainbow Care Connection is one of the first pediatric accountable care organizations (ACO) in the country.
Rainbow Care Connection is a new type of multidisciplinary model geared to produce needed change in pediatric ambulatory care. The model creates meaningful relationships across pediatric primary care providers, hospitals, patients and managed care organizations to drive change and achieve the three objectives of better care, better health and lower cost.
Rainbow Care Connection will impact 200,000 children in northeast Ohio, one-third of whom will be Medicaid enrollees, and will create a sustainable pediatric ambulatory care system that improves health, improves care and reduces costs. Specific goals include: increase primary care provider adherence to evidence-based national quality measures; improve care and health of children with complex chronic conditions through an innovative broad comprehensive care coordination program; improve access and coordination of behavioral health services; and decrease avoidable emergency department visits and hospitalizations.
Project Title: “Shared decision making for preference-sensitive surgery”
Geographic Reach: Ohio
Funding Amount: $6,767,008
Estimated 3-Year Savings: $20,349,081
Summary: Welvie, LLC, is teaming with Anthem Blue Cross and Blue Shield in Ohio to enable patients to make better-informed decisions about preference-sensitive surgery. A significant amount of elective surgery occurs because patients do not fully understand their treatment options, resulting in avoidable patient harm, patient dissatisfaction with care, and higher costs. Through surgery decision-making support, both online and offline, Welvie’s approach enhances consumer experiences in relation to preference-sensitive surgeries, increases surgery literacy, improves surgical outcomes, and reduces the incidence of surgeries where known risks outweigh potential benefits. The program serves traditional Medicare beneficiaries, as well as certain Medicare Advantage PPO enrollees in Ohio. Over a three-year period, Welvie's program will train an estimated 11 workers and will create an estimated 14.82 jobs. The new workforce includes a project director, a medical director, nurse care managers, an implementation specialist, a technology specialist, a reporting analyst, an analytics and provider development team leader, a communication specialist, a training and peer counseling development team leader, a quality assurance and compliance specialist, a finance manager and customer service representatives.