Return-on-Investment (ROI) Analyses of an Inpatient Lay Health Worker Model on 30-Day Readmission Rates in a Rural Community Hospital

被引:2
作者
Cardarelli, Roberto [1 ]
Bausch, Gregory [2 ]
Murdock, Joan [3 ]
Chyatte, Michelle Renee [3 ]
机构
[1] Univ Kentucky, Coll Med, Dept Family & Community Med, Lexington, KY 40506 USA
[2] St Claire Reg Med Ctr, Morehead, KY USA
[3] Univ Cincinnati, Coll Allied Hlth Sci, Cincinnati, OH USA
关键词
30-day readmission; Appalachia; care transition; lay health worker; return on investment; CARE TRANSITIONS INTERVENTION; RANDOMIZED CONTROLLED-TRIAL; AFFORDABLE CARE; PROGRAM; OUTREACH; QUALITY; IMPACT; COST; REDUCTION; DISCHARGE;
D O I
10.1111/jrh.12250
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Purpose: The purpose of the study was to assess the return-on-investment (ROI) of an inpatient lay health worker (LHW) model in a rural Appalachian community hospital impacting 30-day readmission rates. Methods: The Bridges to Home (BTH) study completed an evaluation in 2015 of an inpatient LHW model in a rural Kentucky hospital that demonstrated a reduction in 30-day readmission rates by 47.7% compared to a baseline period. Using the hospital's utilization and financial data, a validated ROI calculator specific to care transition programs was used to assess the ROI of the BTH model comparing 3 types of payment models including Diagnosis Related Group (DRG)-only payments, pay-for-performance (P4P) contracts, and accountable care organizations (ACOs). Findings: The BTH program had a -$0.67 ROI if the hospital had only a DRG-based payment model. If the hospital had P4P contracts with payers and 0.1% of its annual operating revenue was at risk, the ROI increased to $7.03 for every $1 spent on the BTH program. However, if the hospital was an ACO as was the case for this study's community hospital, the ROI significantly increased to $38.48 for every $1 spent on the BTH program. Conclusions: The BTH model showed a viable ROI to be considered by community hospitals that are part of an ACO or P4P program. A LHW care transition model may be a cost-effective alternative for impacting excess 30-day readmissions and avoiding associated penalties for hospital systems with a value-based payment model.
引用
收藏
页码:411 / 422
页数:12
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