Lowering Health Care Costs By Calling People

nurse_phoneThe administration is always saying that the Affordable Care Act will encourage doctors and hospitals to provide care more efficiently and using various new demonstration projects develop ways of lower health care costs without sacrificing profits or rationing care. In today’s Fiscal Times, Merrill Goozner points to a program that’s already doing just that. It’s saving money by encouraging sick patients to take the steps necessarily to avoid repeat and unnecessary follow-up care:

A new study published this week in the New England Journal of Medicine claims there is a better way to engage patients that almost immediately achieves lower health care costs. The approach involves systematic telephone outreach to patients at high risk of serious health problems by trained nurses, who provide them with information about the risks and benefits of their therapeutic options.

A randomized, controlled study with nearly 175,000 participants found that the intervention lowered health care costs by 3.7 percent in the first year compared to those who didn’t get the calls or receive follow-up information. The main savings came from reduced hospitalizations – down 10.1 percent in the group receiving the intervention compared to those who received usual care. Pharmacy costs also fell by 3.6 percent. If this program reached the 160 million Americans with private health insurance, the savings could be huge – more than $10 billion in the first year alone.

In this model, the “staff targeted people considered at high risk of incurring new health care costs – people with chronic diseases like diabetes, chronic asthma, pulmonary disease and heart disease, for instance, or people recently discharged from the hospital.” The nurses made sure that the patients were going through with their prescribed treatments — thus forestalling more expensive complicaitons.

The staff also relied on “electronic medical records to identify patients considering such procedures as prostate, hip, knee, back or uterine surgery, and coronary revascularization” and provided them with “web links, video and print materials before the operation, comparing the risks and benefits of surgery with options like watchful waiting, bedrest, anti-inflammatory drugs and diet and exercise changes.” When fully informed, patients usually choose the less expensive and riskier treatment model.