MIH – A Key Component to Achieving the Triple Aim

Posted on Mon, Nov 28, 2016
MIH – A Key Component to Achieving the Triple Aim

A patient-centered care model that is cost-effective, improves population health and leaves patients satisfied seems too good to be true. However, Evolution Health, an Envision Healthcare company, can do just that. Based on a recent evaluation of a Medicare Advantage population in Florida, its Mobile Integrated Healthcare (MIH) model demonstrated the ability to reduce avoidable Emergency Department (E.D.) and inpatient utilization, lower healthcare costs and, most importantly, improve the patient experience.

“The patient’s health and satisfaction are our top priority,” said Daniel Castillo, M.D., MBA, Chief Strategy and Quality Officer and Executive Vice President of Population Health at Evolution Health. “Our approach to providing individualized, needs based care and our ability to improve population health can significantly impact the future of healthcare.”

MIH provides integrated post-acute care, chronic care and prevention services on a 24 hours a day, seven days a week basis to patients when and where they need it. That accessibility is in part why MIH is so successful.

“We meet patients where they are – both physically and mentally – tailor our care to their specific needs and make patients and their family members an active part of the care team.”

Results from the peer-reviewed published article titled, “Mobile Integrated Healthcare: Preliminary Experience and Impact Analysis with a Medicare Advantage Population,” reveal that patients were receptive to MIH and responded positively to the experience. The patient satisfaction survey shows:
 

  • 97% said their providers sought their opinions, listened carefully and clearly communicated their options
  • 97% said their providers were knowledgeable
  • 96% said they would recommend their providers to family and friends
  • 95.8% net promoter score


He says he is particularly proud of the communication satisfaction score because “it shows that we can communicate effectively across providers and to our patients.”

Dr. Castillo, along with Eric Beck, D.O., MPH, EMT-P, FACEP, Chief Executive Officer for Evolution Health, Brent Myers, M.D., MPH, Chief Medical Officer, and Jonathan Mocko, Evolution’s actuary, led the MIH evaluation.

They leveraged the services of an interprofessional care team that consisted of nurses, social workers, advanced practice providers, emergency medical responders, pharmacists and more to address the Triple Aim — improving population health, enhancing patient experience and outcomes and reducing care costs.

Dr. Castillo says that the patient-centered approach has far-reaching effects on population health, healthcare costs and use of the E.D.

“When we focus on improving patients’ health and providing high-quality, safe and accessible care – through both planned and unplanned interventions – E.D. and inpatient utilization and costs are naturally reduced.”

During the 90-day evaluation period, the interprofessional care team achieved:
 

  • 40% decreased inpatient utilization
  • 21% decreased E.D. utilization
  • 37% decreased inpatient per member per month (PMPM) cost
  • 19% decreased E.D. PMPM cost


Evolution Health’s Medical Command Centers (MCCs) are the heart of the MIH operation. Through the MCCs, patients have 24/7/365 access to clinical professionals such as physicians, advanced practice providers and pharmacists who can provide care over the phone and in-person. Call takers are responsible for assessing patients’ needs and for coordinating and disbursing the appropriate resources.

Part of the multidisciplinary team includes paramedics from Evolution Health’s sister company, American Medical Response (AMR). Merlin Underwood is an MIH paramedic in Broward County and he has been an integral part of the MIH team.

“We get to make sure they get care when they need it, how they need and with whomever they need it – always with quality and safety as our focus,” Underwood said.

As an MIH paramedic, Underwood responds to calls through the MCC. He evaluates patients on-site and determines if it is appropriate to treat them in their current location, in an alternative care setting or if it is best to transport them to the E.D.

As practicing clinicians, paramedics like Underwood can care for patients in the comfort of their homes at 2:00 in the afternoon or at 2:00 in the morning. In doing so, they help save patients long waits in the E.D. and expensive bills.

“You can just see the relief come over their face when you tell them they don’t have to be transported to the E.D.”

The interprofessional care team implements appropriate care programs and scheduled interventions to manage patients’ health. The team is also dedicated to improving patient education and working with patients to understand their needs and become more engaged in their care.

Dr. Castillo says the Evolution Health team is at the forefront of mobile healthcare. He believes that “as we continue to work towards patient-centered care and focus on patient engagement, we can, in fact, improve population health and the current inefficiencies in our healthcare system.”

He says he looks forward to working with his colleagues to create a better experience for both patients and physicians.

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