Gillespie says by working directly with a physician group, EmblemHealth was able to immediately contact discharged patients. As a result of the study, readmissions for the pilot group fell below industry standards and the resulting savings "were more than sufficient to cover the costs of the program," he said.
In 2010 the New York-based health insurance company placed a dedicated healthcare treatment team consisting of a nurse, social worker, pharmacist, and two health navigators in one office of Manhattan’s Physician Group. MPG is a 70-physician multispecialty group with seven offices in Manhattan.
The study compares the 30-day hospital readmissions of a baseline group of 244 patients, who did not receive intervention services, with 298 patients who were part of the pilot program. The pilot participants included commercial, Medicaid and Medicare members.
The pilot participants were supported with point-of-care transition and case management services. The intervention team didn’t focus on patients with a particular disease or condition; rather all discharged patients were provided the opportunity to work with the team.