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Coordinated care pilot improves care, reduces costs

By Mike Sherry for KHI News Service, July 18, 2013

KANSAS CITY, Mo. – Area health care providers are reporting progress in improving care and saving money by coordinating services for some of Missouri’s sickest Medicaid patients.

Ten teams from around the region, including representatives from agencies as far away as Joplin and Trenton, detailed their efforts in a meeting here Tuesday.

The meeting was a wrap-up session for the area organizations participating in the Missouri Medical Home Collaborative, an 18-month project of the Missouri Department of Social Services, the Missouri Foundation for Health and the Health Care Foundation of Greater Kansas City.

The pilot focused largely on Medicaid patients with both chronic medical conditions and serious and persistent mental illnesses.

The aim of medical homes is to provide better-coordinated care to patients so that their health improves and costly hospitalizations and emergency room visits are avoided.

Statewide, the pilot included more than 120 teams serving approximately 34,000 patients, according to Laurel Simmons, a member of the consulting team that worked on the project.

Simmons said participating community mental health centers had worked with 17,000 diabetic patients to help them control the disease and in little more than a year, lab tests showed approximately 40 percent of the patients had acceptable blood glucose levels. Virtually none did when the program started.

“What a stunning result,” Simmons said.

Here are some of the other results reported:

  • Combined figures from the behavioral health and primary care teams at Truman Medical Centers showed that in the span of a year, they had reduced by half (from 6,187 to 3,058) the emergency room visits of patients enrolled in the medical home program
  • Officials at Samuel U. Rodgers Health Rodgers Health Center estimated it had saved the health care system approximately $70,000 over the course of about five months by reducing ER visits among its participants by nearly 20 percent
  • Weight loss: One example was from the North Central Missouri Mental Health Center where a client lost 19 pounds in a year and though she uses a walker, logs more than a mile when she exercises on the YMCA track.
  • The community mental health center in St. Joseph found a severe need for dental work among its medical home clients, which led the agency to secure a $10,000 United Way grant for dental services.

Organizers of the pilot said it would be up to the state whether the Medicaid initiative continues.

Some Kansas-based philanthropies are also involved in efforts to encourage coordinated care among safety-net providers.

The REACH Healthcare Foundation, for instance, has spent about $1.2 million on a medical home initiative that began in 2008.

The foundation has funded organizations on both sides of the state line in the Kansas City area to help safety-net providers earn national certification as “patient-centered medical homes.”

The Topeka-based Sunflower Foundation also has a major initiative aimed at integrating behavioral health and medical care.

Participants in the Missouri pilot said there were challenges getting started.

They said it took a while for staff, including physicians, to get used to a new way of doing business. They also said having a good data-collection system was essential.

“Make friends with your IT Department,” said Kendra Daniels, director of the health care home for Truman Behavioral Health.

At North Central, Healthcare Home Director Tammy Floyd said the initiative had some side benefits for employees.

“Our staff has started becoming healthier themselves,” she said. “Some have quit smoking, some are still working on quitting smoking, (and) and we have had staff do more with exercise programs and weight loss themselves.”

The Health Care Foundation of Greater Kansas City is proud to partner with the KHI News Service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. Because it is committed to objective coverage, HCF exercises no editorial control over the content. The KHI News Service is an editorially independent initiative of the Kansas Health Institute.


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