CareCentrix model has the potential to save billions annually across the entire Medicare Advantage population
Avalere, a leading, independent health care research and consulting firm, today released its novel analysis of the CareCentrix model of technology-enabled and coordinated whole-person post-acute care. The report compared a Medicare Advantage population managed by CareCentrix to a statistically similar non-CareCentrix managed cohort and found a major reduction in the total cost of care in the CareCentrix population, achieved through reduced emergency room visits, hospital utilization, and hospital readmissions.
The study found that the total cost of care for Medicare Advantage members was 44 percent lower in the CareCentrix cohort during the initial 90 days following discharge. The total cost of care savings even extended beyond the 90-day CareCentrix post-acute care management program; 12 months after discharge, the CareCentrix cohort was 27 percent less expensive than the non-CareCentrix cohort.
“We know that our programs provide intelligent care traffic control, substantially reduce healthcare costs, and improve outcomes,” explained John Driscoll, CEO of CareCentrix. “The Avalere analysis demonstrates that our approach is having a much greater positive impact for patients than we imagined. CareCentrix saves money not by limiting access, but through empowering patients and caregivers, addressing clinical and non-clinical needs and making certain patients get the help they need through coordinated, tech-enabled post-acute care.”
Although CareCentrix’s care offerings were initially aimed at avoiding unnecessary hospital admissions, their programs had a consistent impact across the total cost of care. Avalere found the CareCentrix-managed cohort had:
- Readmission rates up to 22 percent lower during the initial 30-, 60-, and 90-day periods following discharge
- A 21 percent reduction in emergency department (ED) visits compared to the baseline pre-discharge ED visits, greater than the 10 percent reduction in non-CareCentrix cohort
- A 71 percent reduction in skilled nursing facility expenditures following discharge compared with a 47 percent cost reduction in the non-CareCentrix group.
Costs across major disease categories evaluated were all lower than the non-CareCentrix managed cohort: musculoskeletal (47%), digestive (21%), respiratory (21%), circulatory (17%) and nervous (12%).
The CareCentrix model is based on three pillars – addressing social needs, making care personal, and powering it with technology. First, CareCentrix uses “whole-patient diagnostics” addressing both clinical and non-clinical factors, such as connecting people with nutrition or transportation services and develops care plans based on patients’ unique needs and personal goals. CareCentrix then keeps patients and caregivers engaged through ongoing digital and nurse coaching. For example, if a patient wants to see her granddaughter get married, CareCentrix uses that to motivate her to complete her physical therapy exercises each day so that she can walk down the aisle after a hip replacement.
All of this is powered by best-in-class technology, including robust data analytics capabilities, telehealth, and remote patient monitoring tools. Finally, CareCentrix shares data and collaborates with the provider and health plan to keep them engaged and informed about what is happening in the home, creating a more coordinated approach.
For the report, Avalere analyzed a population of more than 24,000 individuals using deidentified claims data and retained full editorial control. Patient inclusion criteria for this retrospective analysis included CareCentrix regions of interest and individuals who had at least one discharge between March 25, 2019, and October 31, 2019.
CareCentrix is the leader in health-at-home solutions and is committed to making the home the center of care. Managing care for 17.5 million members through a network of more than 7,400 provider locations, CareCentrix focuses on bringing members home to bring costs down. By drawing on insights from proprietary analytics, and connecting end-to-end clinical, social and caregiver services, CareCentrix eliminates unnecessary hospital readmissions, closes gaps in care, and reduces fragmentation. And ultimately, to help more people live, heal, and age at home.