Going Beyond Clinical Care to Reduce Health Care Spending
Findings From the J-CHiP Community-based Population Health Management Program Evaluation
Bibliographic Data
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants. OBJECTIVES: To report the impact of a community-based program on cost and utilization from 2011 to 2016. DESIGN: Difference-in-difference estimates were calculated for an inclusive cohort of J-CHiP participants and matched nonparticipants. The analysis was replicated for participants with a CM and/or HBS to estimate the differential impact with more intensive program services. SUBJECTS: A total of 3268 high-risk Medicaid and Medicare beneficiaries (1634 total J-CHiP participants, 1365 with CM and 678 with HBS). OUTCOME MEASURES: Paid costs and counts of emergency department visits, admissions, and readmissions per member per year. RESULTS: For Medicaid, costs were almost $1200 per member per year lower for participants as a whole, $2000 lower for those with an HBS, and $3000 lower for those with a CM; hospital admission and readmission rates were 9%-26% lower for those with a CM and/or HBS. For Medicare, costs were lower (-$476), but utilization was similar or higher than nonparticipants. None of the observed Medicaid or Medicare differences were statistically significant. CONCLUSIONS: Although not statistically significant, the results indicate a promising innovation for Medicaid beneficiaries. For Medicare, the impact was negligible, indicating the need for further program modification
Case management · Cohort · Emergency department · Environmental health · Family medicine · Health care · Health services research · Medicaid · Population · Public health · Chronic Disease Management Strategies · Diabetes Management and Education · Food Security and Health in Diverse Populations · Medicine · Nursing · Gerontology
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| Citation span | 2019 - 2025 (7) |
| Highly cited | No |