5-Year Medicaid Cost Savings from Medical Duplexes: The Elder Partnership for All-Inclusive Care 6 2 11
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1. The study integrated home and community-based services through a local aging agency with medical care provided by an academic health system's in-home primary care program to form an interdisciplinary team called E-PAC. 2. E-PAC served 92 Medicaid and non-Medicaid clients over 5 years. E-PAC clients had lower nursing home use, longer survival times, and 23% lower Medicaid costs on average compared to similar waiver clients. 3. Integrating medical and support services through a patient-centered model like E-PAC resulted in estimated savings of $4.7 million for Medicaid and Medicare over 5 years for the matched cohort through increased community tenure and lower costs.
![5-Year Medicaid Cost Savings from Medical Duplexes: the ELDER PARTNERSHIP FOR ALL-INCLUSIVE CARE (E-PAC) Linsey O’donnell 2 ; Jean Yudin 2 ; Ann Dannish 3 ; Barbara Boland 2 ; Steve Touzell 3 ; Mary Ann Forciea 2 ; Lesley Carson 2 ; Johanne Louis 2 Bruce Kinosian 1,2 1 Department of Veterans Affairs, Philadelphia, Pennsylvania ; 2 University of Pennsylvania, Philadelphia, Pennsylvania ; 3 Philadelphia Corporation for Aging, Philadelphia, Pennsylvania ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Key Learnings Medicare Costs EPAC: Controls (1998); EPAC sample:HCC (2008) EPAC:Control =.48 (1998) EPAC:HCC predicted =.49 (2008) 5- year Community Survival EPAC, HCBS/Waiver control, LIFE (PACE), National HCBS control Total 5-year Cost $2.3M saving for 4360 member months (23%) $6740/ Year of Life Saved Medicaid only, N=92 $4.7M - $6.4M saving for combined Medicaid/Medicare $7.5M Average Monthly Cost EPAC /Waiver Controls ,[object Object],[object Object],[object Object],[object Object],[object Object],Background 1. Create a high-functioning inter-organization, interdisciplinary team to provide all-inclusive care to frail elders in the community. 2. Increase the share of total survival spent in the community for frail elders. 3. Reduce long-term Medicaid costs to provide home and community based care to frail elders . 4. Estimate likely performance of an integrated care/Independence at Home practice Objectives . Intervention Patient Characteristics (N=92 EPAC/216 Waiver/84 Options) ADLs (mean) Age 82 (+/- 8) EPAC: 3.7/48% 5-6 86% Female HCBS: 2.8/24% 5-6 PACE reference:3.8 /44% 5-6 E-PAC 2 (2004-2009) (N=92/4360 member months) Waiver/Options Controls (N=216/ 6910 member-months ) Hospital 3.8/100 mm Long-term Nursing Home 5.7%/yr 24.9% Community Survival/ Survival (5-year) 38% /43% 20%/28% HCBS Care Plan mean cost/month Est. mean HCC Annual/ 5-yr Total $1942 +/- 1117 3.55 $41,962/$15.05M $1084+/- 477 Medicare Savings Annual/ 5-yr Total @ .48 @ .37 $20,054/$7.22M $15,458/ $5.5M . Findings to date](https://image.slidesharecdn.com/kinosianbruce5yearmedicaidcostsavingsfrommedicalduplexes6211-110602101223-phpapp01/85/5year-medicaid-cost-savings-from-medical-duplexes-the-elder-partnership-for-allinclusive-care-6-2-11-1-320.jpg)
