Impact Of Health Care Delivery System Innovations On Total Cost Of Care

Area of Science:

• Health Services Research
• Health Economics
• Healthcare Innovation

Background:

• Advancing healthcare reform through delivery system innovations is a key focus.
• Evaluating the success of specific innovations is challenging due to limited studies.
• The Center for Medicare and Medicaid Innovation (CMMI) funded numerous healthcare innovations.

Purpose of the Study:

• To analyze the impact of 43 ambulatory care programs funded by CMMI on total cost of care.
• To assess the cost-saving potential of common components within these healthcare innovations.
• To identify which innovation components are most effective in reducing healthcare expenditures.

Main Methods:

• Analysis of 43 ambulatory care programs funded by the Health Care Innovations Awards.
• Independent evaluation of innovations' impact on total cost of care using multivariable difference-in-differences models.
• Meta-regression analysis to assess the effects of common innovation components on costs.

Main Results:

• Most innovations did not demonstrate a significant effect on total cost of care within the first two years.
• Innovations incorporating health information technology (HIT) and community health workers (CHW) yielded the greatest cost savings.
• Programs targeting clinically fragile patients showed relatively large cost savings, though not statistically significant.

Conclusions:

• While some delivery system innovations show potential for cost savings, particularly those using HIT or CHWs and targeting complex patients, most did not reach conventional significance levels in initial analyses.
• Larger meta-analyses are required to definitively establish the cost-saving potential of various delivery system innovations.
• Further research is needed to understand the long-term impact and scalability of successful healthcare innovations.