移动综合医疗:与医疗保险优势人口的初步经验和影响分析
Daniel J Castillo1, J Brent Myers1, Jonathan Mocko1
1Evolution Health, Dallas, TX, USA.
Journal of health economics and outcomes research
|September 4, 2023
概括
移动综合医疗 (MIH) 显著减少了医疗保险优势人口的急诊室和住院患者的利用和成本. 这种以患者为中心的护理协调计划显示了对医疗保健效率和患者结果的有希望的结果.
科学领域:
- 医疗保健管理的管理
- 人口健康 人口健康
- 临床信息学 临床信息学
背景情况:
- 移动综合医疗 (MIH) 是一种以患者为中心的人口管理模式.
- 医院利用多专业团队,及时提供符合需求的患者护理.
- 护理提供是灵活的,发生在家庭或其他环境,基于患者的需求和选.
研究的目的:
- 评估MIH护理协调计划对医疗保险优势PPO (MAPPO) 群体的影响.
- 评估MIH对潜在可避免的紧急医疗服务,急诊室和住院住院的使用的影响.
- 将MIH参与者与风险匹配的非参与者以及历史成本/利用数据进行比较.
主要方法:
- 一个MIH团队为MAPPO群体实施了护理协调计划.
- 风险分配和有针对性的干预措施被用来减少利用.
- MIH参与者与匹配的队列和历史索赔数据进行了比较.
主要成果:
- MIH参与者在急诊室使用率下降了21%,在住院患者使用率下降了40%.
- 成本也大幅下降,急诊室PMPM成本下降了19%,住院PMPM成本下降了37%.
- 初步趋势表明,会员满意度和患者激活度有所改善.
结论:
- MIH护理协调计划在MAPPO群体的利用率,成本,会员经验和患者激活方面显示出有利的趋势.
- 实施MIH计划是可行的.
- 这些发现强烈表明,对人口健康,患者体验和医疗保健成本有有益影响.
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