According to the Centers for Disease Control and Prevention (CDC), asthma-related costs in the United States run more than $50 billion annually — with that number rising yearly. That leaves patients, hospitals, insurers, and employers all looking for new ways to reduce those costs. One of the leading non-profit health maintenance organizations, Parkland Community Health Plan Inc. (PCHP), has succeeded in decreasing some of these costs through its Data Science & Technology Program.
What is Parkland Community Health Plan (PCHP)?
Parkland Community Health Plan (PCHP) is a health maintenance organization that covers a seven-county area centered on Dallas. With 30 contracted hospitals, 1,000 primary care providers, more than 3,000 specialists, and 400,000 patient members, PCHP forms a bridge to connect Medicaid recipients to a “medical home” or one place they can always turn to for health care services and information. As difficult as it can be for many people to negotiate and navigate through Medicaid, this plan is essential in providing people with a one-stop spot where they can have their medical needs addressed.
How was technology used in PCPH plans?
Parkland Community Health Plan used predictive health care models developed by PCCI — a Dallas-based non-profit tech corporation — to address the highest risk asthma patients in the PCHP network. For every asthma patient in its system, PCHP ran a risk analysis. Patients found to be at high risk for Emergency Department (ED) visits were placed on a case manager work list that was then given to the patient’s primary care provider. Those providers reached out to the high-risk patients in order to provide more tailored treatments in an effort to better control patients' asthma and to prevent ED visits.
Benefits of the technology interventions
The efforts of the PCPH-PCCI collaboration significantly reduced the costs of asthma care within the PCPH system. Emergency Department visits decreased almost five percent and the average cost per asthma patient decreased by almost 40 percent, from an average of over $1,284 down to $765.
While these numbers are hugely significant, the most important thing to remember is that they are reflecting better asthma control — and healthier patients. It’s truly a win-win.
If these types of technologies were applied with the same success across the board, to all asthma patients, asthma care in the United Stateould see savings upward of $20 billion dollars per year, based on the CDC's noted $50 billion in asthma costs per year.
What does this mean for patients?
While this model tracked patients with Medicaid across a relatively small area, if applied to all Medicaid patients and Americans utilizing a classic health care insurance plan it has the potential to greatly decrease the cost of care. Reducing health care costs might, in turn, decrease the amount that patients pay for insurance. In 2013, medical bills were listed as one of the main reasons people file for bankruptcy. A decrease in the cost of care could positively affect countless American families — while having a huge impact on patients' quality of life.
Check out your health plan to see what option are available to better manage any chronic conditions you might be dealing with. The time you invest in improving your health will not be wasted.
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Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).