Pilot Program Shows the Home-Based, Tech-Enabled Model of Care Improves Healthcare and Lowers Treatment Costs for the Top 1% of Most Medically Complex Patients
SAN DIEGO, April 8, 2022 /PRNewswire-PRWeb/ -- In healthcare today, the U.S. has the most expensive healthcare and the worst outcomes among industrialized nations. A closer look at healthcare spending reveals the neediest patients consume the bulk of the healthcare budget. A recent study found the top 1% of the highest cost patients (3.3 million people) in the U.S. consume over 20% of the total national healthcare budget. In California, the top 1% of Medicaid patients consume 36% of the $100 billion Medi-Cal budget.
"High needs" patients, particularly the top 1%, are the most medically complex and underserved, routinely dependent on the emergency department for care, creating a tremendous cost burden for the healthcare system. Presidium Health is working to lower those costs, but not by reducing services. The company offers primary care services to the neediest patients, offering each an efficient, home-based model of care with 24/7 access and an integrated concierge team that provides comprehensive social services support.
While most healthcare companies cater services to the general population, Presidium Health's business model targets those with the highest needs, particularly the underserved patients receiving Medicaid benefits. The company seeks out the 1% of the neediest patients and provides personalized care, prioritizing their health and overall well-being. Presidium Health provides each patient with 24-hour concierge service: from house calls to in-home labs and x-rays - to refilling medications to simply listening to a patient's concerns. Beyond the traditional medical services, Presidium Health offers wrap-around services targeting social determinants of health that are often a significant contributor to the overutilization of the emergency department. Everything from housing, food, transportation, financial assistance, and other social services support are integrated into Presidium Health's care delivery model. These interventions help Presidium Health achieve the holy grail of healthcare, the "quadruple aim": higher patient and provider satisfaction and improved clinical outcomes while reducing the total cost of care.
"Whether it is a cell phone, a ride to refill medications, or a listening ear, we've found some of the care solutions for these patients are inexpensive actions that can prevent the need for an expensive and often risky trip to the emergency room," said Pouya Afshar, M.D. M.B.A. and Co-Founder of Presidium Health. "We not only provide essential healthcare but whole-person care as well. Whether it is substance abuse, behavioral disorders, or the result of living in substandard living conditions, we treat the full spectrum of conditions and situations that can impact a patient's health. Our home-based care solution results in efficiencies, an improved experience for the patient, better health outcomes, and lower costs."
Presidium Health recently completed a pilot program with San Diego's largest non-profit health plan, Community Health Group (CHG). In keeping with Presidium's model of targeting the top 1% of the highest-cost patients, a total of 93 individuals were included in the pilot, each with an average healthcare cost that was nearly $200,000 per year (total annual cost of $17.9 million for 93 patients). Not surprisingly, most of the costs for these patients were attributed to the overutilization of the ER and hospital. After one year of services under Presidium Health, hospitalizations were lowered by 53%, reducing the total cost of care to $11.9 million. "While this was a relatively small sample size, it is unprecedented to show $6 million of annual savings on just 93 patients," said Pouya Afshar. Not only was the pilot a financial success, but many patients in the pilot program also raved about the personalized care they received. Given the success of the pilot program, CHG has committed to expanding Presidium's services to more of its members in San Diego County.
About Presidium Health
Presidium Health provides a home-based, tech-enabled model of care designed to improve outcomes and lower healthcare costs for the top 1% of the most medically complex, socially disadvantaged, and highest cost patients. The company was founded in 2015 by Pouya Afshar M.D., M.B.A., who currently serves as the Co-Founder and Chief Executive Officer, and Ashkan Hayatdavoudi, M.D., J.D. Co-Founder, and Chief Medical Officer. Presidium Health aims to disrupt the current healthcare model to simultaneously cut the cost of care and provide more personalized care to those most in need with an ultimate goal of better health outcomes.
Media Contact
Jill Budik, Presidium Health, 1 2124898774, [email protected]
SOURCE Presidium Health
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