A Program Evaluation of a Peri-Urban, Multi-Location Care Coordination Program in Georgia and Comparative Analysis of Other United States Care Coordination Programs for Uninsured, High-Risk Patients to Develop Promising Practice Recommendations
Date of Award
Master of Public Health (MPH)
Dr. Rodney Lyn
INTRODUCTION: Having access to care allows individuals to enter a healthcare system and receive medical care that improves their quality of life. Unfortunately, access to care and health outcomes are typically related to one’s insurance status. Care coordination programs work to reduce this barrier for high-need patients. One such program is the Sams Care Coordination Program, which connects local hospitals with charity clinics to expand the clinics' capacity by stabilizing staffing, enhancing communication through the shared use of the Epic electronic medical records (EMR) system and providing intensive case management through the use of licensed medical social workers.
PURPOSE: This paper will evaluate the Sams Care Coordination Program at Piedmont Healthcare through a cost-avoidance and hospital utilization analysis. Additionally, this paper will provide promising program practices and sustainability options for continued funding.
APPROACH: The cost-benefit and hospital utilization analysis will be conducted using program data from FY14 to FY16. A literature review will provide an in-depth look at care coordination models, other existing programs, funding options and promising practice recommendations. A culmination the evaluation and review of literature will be used to guide promising practice recommendations as well as options to sustain the Sams Program funding.
EVALUATION: Over the last two and half years, Piedmont has invested more than $2.4 million dollars in the Sams Care Coordination Program including hospital services, staffing, technology and program support. A cost avoidance analysis shows that Piedmont has saved $328,515 in direct costs and $1,214,667 in assumed costs. A hospital utilization study reveals that nearly 60 percent of Sams eligible patient emergency department (ED) visits are reduced annually through the Sams Program and the program is capable of reducing ED encounters by over 1,800 visits each year.
RECCOMENDATIONS: The partner clinics should formalize agreements of responsibility with Piedmont Healthcare and their local entities, including metrics for regular reporting. All clinics should be provided with equal access to the Epic EMR system to capitalize on its capabilities in sharing and analyzing patient and population data. Case management should provide increased patient education on emergency department utilization and self-management of chronic disease. As a group, the clinic and hospital leadership should determine the best route of sustained funding past the summer of 2017.
Parker, Amanda, "A Program Evaluation of a Peri-Urban, Multi-Location Care Coordination Program in Georgia and Comparative Analysis of Other United States Care Coordination Programs for Uninsured, High-Risk Patients to Develop Promising Practice Recommendations." , Georgia State University, 2017.