MIH Decreases Emergency and Inpatient Use, Costs, New Study Finds

GREENWOOD VILLAGE, Colo. — Envision Healthcare Holdings, Inc. (Envision) today announced results from a groundbreaking study on mobile integrated healthcare’s (MIH) impact on avoidable utilization of emergency medical services (EMS), the emergency department (ED) and medical inpatient admissions. Using data from an MIH care coordination program of more than 60,000 Medicare Advantage PPO (MAPPO) members, the results of study’s 1,074 include a 40 percent decrease in inpatient utilization and 37 percent decrease in inpatient per member per month (PMPM) costs. 

MIH improves patient outcomes and lowers costs by engaging a remote comprehensive clinical team to match resources with patient needs. The MIH program at the center of the study was administered by a medical practice managed by Evolution Health, an Envision company. Evolution Health provides MIH in homes and other alternative settings using physician-led, interprofessional care teams. These teams provide patient-centered, needs based, acute and chronic care, as well as prevention services, on a 24/7 basis.

The study, which focused on coordinated transitions from one care setting to another (e.g., from the hospital to the patient’s home, or home to a skilled nursing facility), tracked the implementation of an MIH intervention across a state-wide MAPPO population in Florida for a 90-day period beginning in January 2016. Members were mostly female, and the average age of participants was 71.2. Key results across the population include:

• 40% decrease in inpatient utilization;

• 37% decrease in inpatient PMPM cost;

• 21% decrease in ED utilization;

• 19% decrease in ED PMPM cost.

Member satisfaction and activation measures also showed favorable preliminary trends.

“These findings are concrete evidence of our long-held belief that MIH is the most promising collaborative opportunity in healthcare today,” said study co-author Daniel J. Castillo, MD, MBA, Chief Strategy and Quality Officer and Executive Vice President of Population Health System Effectiveness with Evolution Health. “MIH fast-tracks pursuit of the Triple Aim, providing patients the care they need in appropriate settings, leading to more positive experiences and lower overall costs.”

The study results are particularly significant given the healthcare industry’s attuned focus on identifying new strategies for lowering costs and increasing patient health outcomes. The Centers for Medicare & Medicaid Services (CMS) predicts Medicare enrollment will increase to 18.5 million members in 2017, a 60 percent jump from 2010. Research suggests that approximately $600 million could be saved annually if Medicare members with low-acuity needs were transported by EMS to settings other than the ED.

“MIH addresses a population’s unmet needs by pairing clinicians with technology, tools and other resources to provide customized care in a cost-effective manner,” said Eric H. Beck, D.O. MPH, Chief Executive Officer of Integrated Delivery, and President and Chief Executive Officer, Evolution Health. We’re encouraged and motivated by these findings, and confident that future studies of the MIH model’s use will yield similar results. Through communication, collaboration and coordination, we can make significant strides toward achieving true population health.” 

Results of the program are highlighted in the article, ‘Mobile Integrated Healthcare: Preliminary Experience and Impact Analysis with a Medicare Advantage Population,’ newly published by the peer-reviewed Journal of Health Economics and Outcomes Research. The article’s co-authors include Envision executives Dr. Castillo, J. Brent Myers, M.D. and Dr. Beck.

Envision Healthcare Holdings, Inc., offers an array of physician-led healthcare-related services to consumers, hospitals, healthcare systems, health plans and local, state and national government entities. The organization provides care across a broad patient continuum via American Medical Response, Inc. (AMR), EmCare Holdings, Inc. (EmCare) and Evolution Health, LLC (Evolution Health). AMR provides community-based medical transportation services, including emergency (‘911’), non-emergency, managed transportation, air ambulance and disaster response. EmCare’s integrated facility-based physician services include emergency, anesthesiology, hospitalist/inpatient care, intensive medicine, obstetrics and gynecology, radiology, tele-radiology and surgery. Evolution Health’s innovative and comprehensive care coordination solutions result in improved patient care delivery across a number of healthcare settings. Envision Healthcare is headquartered in Greenwood Village, Colorado. For additional information, visit www.evhc.net.