Post Updated May 5, 2013 - The thorough article by Ezra Klein in the Business section of the Sunday Washington Post on 4/28/2013 (CLICK HERE) and available at WonkBlog (CLICK HERE) was based on Mr. Klein spending 2 full days directly observing the work of our nursing team and learning about our program. Much of the online buzz about the article, the HQP program, and the merits or pitfalls of continued CMS support for HQP's program has been thoughtful – generally leaning in favor of continued support for HQP's work. Unfortunately, most discussions are taking place without important data about the HQP program's performance.
For example, very few online discussants have been able to find (not surprisingly) the 4th Report to Congress on the Evaluation of the Medicare Coordinated Care Demonstration commissioned by CMS and compiled by Mathematica Policy Research, Inc. March 2011 which reported:
Among high-risk participants, HQP’s model of Community-based Advanced Care Management reduced deaths -30.4% (p=0.03), hospitalizations -38.8% (p<0.01), emergency room visits -37% (p=0.05), average monthly Part A and B Medicare expenditures -$511 (-35.5%, p=0.01), and average monthly net expenditures (including program fees) -$397 (-27.6%, p=0.05). To see this report in its entirety CLICK HERE - scroll down past the nearly blank cover page to get to the report.
For a full summary of all primary studies reporting on the HQP program CLICK HERE.
Note also that the HQP program has also been evaluated by Aetna for more than 3 years and according to Aetna's Medical Economics division found to reduce hospitalizations and save money among high-risk Medicare Advantage members. See previous press releases by Aetna on this HERE (Jan 2013) and HERE (Nov 2011). Aetna has just renewed and expanded their contract with HQP through 2015.
For more information about HQP visit http://hqp.org
Thanks for everyone's interest and thoughtful, considered discussions. In short, the HQP program has shown significant net savings, fewer hospitalizations, and better health outcomes in higher-risk Medicare beneficiaries. To date it has not saved net dollars among low / moderate risk populations. The model (what we call an Advanced Preventive Service) differs from many nurse care management programs in having a more extensive portfolio of preventive services and more rigorous process monitoring to manage service delivery reliability. We believe these characteristics are reproducible and scaleable, but of course that needs to be tested and proven. In partnership with others interested in advancing this field and on behalf of millions of chronically ill older Americans who could benefit from such care, we hope to have that opportunity.
Best,
Ken Coburn, MD, MPH
CEO and Medical Director, Health Quality Partners
Among high-risk participants, HQP’s model of Community-based Advanced Care Management reduced deaths -30.4% (p=0.03), hospitalizations -38.8% (p<0.01), emergency room visits -37% (p=0.05), average monthly Part A and B Medicare expenditures -$511 (-35.5%, p=0.01), and average monthly net expenditures (including program fees) -$397 (-27.6%, p=0.05). To see this report in its entirety CLICK HERE - scroll down past the nearly blank cover page to get to the report.
For a full summary of all primary studies reporting on the HQP program CLICK HERE.
Note also that the HQP program has also been evaluated by Aetna for more than 3 years and according to Aetna's Medical Economics division found to reduce hospitalizations and save money among high-risk Medicare Advantage members. See previous press releases by Aetna on this HERE (Jan 2013) and HERE (Nov 2011). Aetna has just renewed and expanded their contract with HQP through 2015.
For more information about HQP visit http://hqp.org
Thanks for everyone's interest and thoughtful, considered discussions. In short, the HQP program has shown significant net savings, fewer hospitalizations, and better health outcomes in higher-risk Medicare beneficiaries. To date it has not saved net dollars among low / moderate risk populations. The model (what we call an Advanced Preventive Service) differs from many nurse care management programs in having a more extensive portfolio of preventive services and more rigorous process monitoring to manage service delivery reliability. We believe these characteristics are reproducible and scaleable, but of course that needs to be tested and proven. In partnership with others interested in advancing this field and on behalf of millions of chronically ill older Americans who could benefit from such care, we hope to have that opportunity.
Best,
Ken Coburn, MD, MPH
CEO and Medical Director, Health Quality Partners