Washington State’s Health Homes Program Saves $21.6 Million Focusing on Health Activation

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Washington Health Home program has required use of Insignia’s Patient Activation Measure® (PAM®) to guide member support and measure performance.

Senior Business Analyst for Optum.

Nicole Bishop

The great thing about using the Patient Activation Measure assessment: it allows our team to measure something that was previously unmeasurable. It helps them match the support to the person’s level of readiness.

The Washington State Health Homes Program, initiated in July of 2013 as part of HealthPath Washington’s Medicare-Medicaid initiatives, is gaining momentum and garnering attention since a preliminary federal report revealed a $21.6 million (over 6%) savings in Medicare spending relative to a comparison group during the first demonstration performance period from July 2013 – December 2014.*

The program provides care coordination services to high-cost, high-risk Medicaid and Medicare/Medicaid (dual) eligible clients. It is organized around the principles of patient activation, to support enrollees and guide change as they take steps to improve their own health. By decreasing duplication of services and improving individually-tailored care plans, the program helps to reduce the progression of chronic disease, lower emergency room visits, prevent hospital admissions, and improve individual health self-management.

A key element to the success of the Health Homes program is the required use of Insignia’s Patient Activation Measure®(PAM®) survey, the gold standard tool for assessing a person’s health self-management abilities, as well as a recommended complementary measure for caregiver activation and the Coaching for Activation® (CFA) system. PAM determines an individual’s level of health activation (knowledge, skills and confidence) for self-managing health and healthcare issues. Care coordinators administer PAM and care administrators have been urged to use each patient’s activation score to develop a highly tailored healthcare action plan using guidance from CFA.

“The great thing about using the Patient Activation Measure assessment: it allows our team to measure something that was previously unmeasurable. It helps them match the support to the person’s level of readiness. It shows respect for the individual, builds trust, and creates a relationship that results in better health outcomes,” said Nicole Bishop, Senior Business Analyst at Optum.

The Medicare savings is significant since 9 million dual-eligible patients, account for 40 percent of all Medicaid spending and 27 percent of all Medicare spending nationwide. Care expenses total about $350 billion a year, or 9 percent of the $4 trillion annual health care tab across the United States.

“This report confirms what we have experienced: Health Homes have demonstrated significant promise, especially the reduction of inpatient hospital admissions and avoidable emergency room visits,” said HCA State Medicaid Director, MaryAnne Lindeblad.

An estimated 40 percent of Washington State’s 115,000 citizens who are eligible for both Medicare and Medicaid are expected to enroll in Health Homes.

“The Health Homes program in Washington truly demonstrates how measuring activation and building appropriate care plans are essential to providing person-centered care, positively impacting health outcomes and reducing costs,” said Chris Delaney, CEO of Insignia Health. “We are very proud to be a part of the solution for reducing costly hospital admissions and emergency services, while also enabling our clients to attain healthcare reform benchmarks in an increasingly value-based healthcare environment.”

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About Insignia Health: Insignia Health is the gold standard provider of patient activation solutions that pinpoint population health risk, improve health outcomes, reduce healthcare costs and increase patient/member satisfaction. Our Patient Activation Measure® (PAM®) is a predictive powerhouse backed by over a decade of health activation research and insight gained from supporting hospitals, health systems, health plans, life science firms and government agencies around the globe. Our products and services help organizations exceed performance objectives by measuring activation and tailoring care programs to specific activation levels. We strive to lessen disease, and reduce illness burden and premature deaths around the world. Insignia Health is headquartered in Portland, Oregon. Visit http://www.insigniahealth.com, email info@insigniahealth.com or follow us on Facebook and Twitter.

*Measurement, Monitoring, and Evaluation of the Financial Alignment Initiative for Medicare-Medicaid Enrollees. Preliminary Findings from the Washington MFFS Demonstration. January 4, 2016. https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/Downloads/WAEvalResults.pdf

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Sherry McVey
Insignia Health
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