Fewer posthospital inpatient admissions and decreased costs were seen in a large group of patients with medically complex chronic conditions who were referred to and seen at an outpatient critical care transition clinic compared with those who were referred but did not attend the clinic, a recent study found.
“Reducing hospital admissions in patients with multiple complex chronic conditions is both a quality indicator and cost-effective to health care systems,” the study authors wrote in the September 2021 issue of The American Journal of Managed Care.
Healthy transition clinic goals
Common conditions of the patients in the study included congestive heart failure, chronic obstructive pulmonary disease, high blood pressure, diabetes mellitus and complications, acute myocardial infarction, substance abuse and renal and liver disease.
These patients were discharged from Ascension St. Vincent, an 822-bed tertiary/quaternary acute care hospital in Indianapolis, or its emergency department (ED) to the Ascension St. Vincent Medical Group Healthy Transitions Clinic (HTC) between March 1, 2015, and Feb. 29, 2016. The compared cohorts comprised patients who attended the HTC and those who did not.
According to the authors, the main goals of the HTC are to:
- Help high-risk patients better manage their chronic diseases
- Reduce encounters at EDs or hospital admissions
- Improve the cost effectiveness of healthcare services
“Transitional care services reduce ED encounters and inpatient stays,” the authors wrote, citing a previously published study.
“The benefits to patients, hospital systems, and payers from reduced hospital encounters include improved health, disease management, and financial savings,” the authors of the September study wrote. “As the U.S. health care system changes from fee for service to value based, efficiently managing medically complex chronic conditions is increasingly important.”
According to Shawn Stack, HFMA’s director of perspectives and analysis, programs like HTC “are designed around patient-centered care and effective case management — an approach that has repeatedly influenced healthier outcomes and long-term cost savings. Unfortunately, programs like HTC are still not the norm in the U.S., given that most healthcare continues to be delivered through fee-for-service models that do not reward health plans and providers for collaboratively managing and delivering better long-term health.”