Headline

A home-based palliative care program in a full-risk financial arrangement showed consistent cost savings and lower hospital utilization across a 10-year period.

Context

Sharp HealthCare’s Transitions program is designed to help patients with cancer, heart failure, chronic obstructive pulmonary disease (COPD), and dementia manage their serious illnesses at home. The Transitions program treats beneficiaries in Medicare Advantage (MA) contracts in which Sharp HealthCare is at full risk for the cost of care. In this program, an interdisciplinary team conducts in-home medical consultations for patients as well as educational and psychological support for caregivers. The 24/7 crisis support helps patients manage their symptoms at home and avoid costly hospital admissions. This case study examines the impact of the Transitions program across a 10-year period, from its launch focusing on heart failure patients to its expansion to serve patients with other advanced illness diagnoses. 

Findings

Between the years of 2007 to 2017, the Transitions program cut hospital admissions by half, lowered intensive care unit admissions within 30 days of death, and reduced overall costs for over 5,000 patients.  Most notably, during this 10-year period, Sharp Healthcare realized net savings equivalent to a 6.6 percent return on investment for people with cancer and 4.2 percent for people with dementia who participated in the Transitions program.

Takeaways

Sharp HealthCare’s implementation and growth of their home-based palliative care program illustrates the benefits that can accrue when an organization takes on risk for the cost of MA beneficiaries’ health care and as a result has the flexibility to strategically invest in more comprehensive services.