Study Provides Analysis of Largest Population to Date in MIH Program

Hats off to Daniel Castillo, Brent Myers, Jonathan Mocko & Eric Beck on the recent publication of the Evolution Health experience with a statewide geriatric population managed under a Mobile Integrated Health practice model approach.

They were able to demonstrate:

• A 40% decrease in inpatient utilization;
• A 37% decrease in inpatient member cost;
• A 21% decrease in ED utilization;
• 19% decrease in ED member cost.

Interestingly, patient satisfaction and activation measures also showed favorable preliminary trends.

It reviewed potentially avoidable emergency department (ED) utilization and inpatient medical admissions for high-risk patients in Evolution Health's Florida practice. The goal of this review was to examine the collective impact around improving patient activation and patient experience while also reducing preventable utilization of the ED and hospital.

The results demonstrated statistically significant improvement in all utilization and cost trends. Patients participating in the program demonstrated a 40% reduction of preventable in-patient medical hospitalizations and 21% reduction in preventable ED utilization.

There was also notable decrease in the corresponding cost trend, 37% reduction in avoidable medical hospitalization and 19% reduction in avoidable ED costs.

Patient activation improved. The initial aggregate patient activation measure (PAM) improved over the duration of program participation, and this increase may correlate to an expected decrease in hospital utilization based on previous peer-reviewed publications.

Patient experience and satisfaction scores reported 97% agreed or strongly agreed that their clinician was knowledgeable, and 96% indicated they would recommend the services to their friends and family.

This initial impact analysis of the EvH MIH program for a high-risk population demonstrates promising trends regarding improving patient activation and experience, as well as reducing avoidable healthcare utilization and cost.

Reading the article, I was reminded of our initial discussions four years ago on the value of a new way to manage patients outside the hospital. This fits into the “You’ve come a long way, baby” category.

Nice work and promising results.

Ed Racht, MD is the chief medical officer for American Medical Response and associate medical director for Evolution Health. He has more than 20 years of experience in emergency medical services and healthcare systems. Previously, he served as the chief medical officer and vice president of medical affairs for Piedmont Newnan Hospital in metro Atlanta and as medical director for the Austin/Travis County EMS System in Texas, which was nationally recognized for its collaborative approach to resolving challenging health care integration issues. He has served three successive terms on the Virginia State Governor's EMS Advisory Board and chaired the state of Texas Governor's EMS and Trauma Advisory Council for 10 years.