A telephone-based care-management strategy reduced average monthly medical costs ($213.82 vs. $221.78, P=0.05) and annual hospital admissions by 10.1% (P<0.001) compared to usual support.
RCT (n=174,120)
Stratified
Does an enhanced telephone care-management strategy reduce medical costs and hospital admissions in subjects with selected medical conditions and predicted high health care costs?
A targeted telephone care-management program with expanded eligibility significantly reduced medical costs and hospitalizations in a large population-based cohort.
Absolute Event Rate: 213.82% vs 221.78%
p-value: p=0.05
BACKGROUND: Studies have shown that telephone interventions designed to promote patients' self-management skills and improve patient-physician communication can increase patients' satisfaction and their use of preventive services. The effect of such a strategy on health care costs remains controversial. METHODS: We conducted a stratified, randomized study of 174, 120 subjects to assess the effect of a telephone-based care-management strategy on medical costs and resource utilization. Health coaches contacted subjects with selected medical conditions and predicted high health care costs to instruct them about shared decision making, self-care, and behavioral change. The subjects were randomly assigned to either a usual-support group or an enhanced-support group. Although the same telephone intervention was delivered to the two groups, a greater number of subjects in the enhanced-support group were made eligible for coaching through the lowering of cutoff points for predicted future costs and expansion of the number of qualifying health conditions. Primary outcome measures at 1 year were total medical costs and number of hospital admissions. RESULTS: At baseline, medical costs and resource utilization were similar in the two groups. After 12 months, 10. 4% of the enhanced-support group and 3. 7% of the usual-support group received the telephone intervention. The average monthly medical and pharmacy costs per person in the enhanced-support group were 3. 6% (7. 96) lower than those in the usual-support group (213. 82 vs. 221. 78, P=0. 05) ; a 10. 1% reduction in annual hospital admissions (P<0. 001) accounted for the majority of savings. The cost of this intervention program was less than 2. 00 per person per month. CONCLUSIONS: A targeted telephone care-management program was successful in reducing medical costs and hospitalizations in this population-based study. (Funded by Health Dialog Services; ClinicalTrials. gov number, NCT00793260. )
Wennberg et al. (Wed,) conducted a rct in Selected medical conditions and predicted high health care costs (n=174,120). Telephone-based care-management strategy (enhanced-support) vs. Usual-support group was evaluated on Total medical costs and number of hospital admissions at 1 year (p=0.05). A telephone-based care-management strategy reduced average monthly medical costs ($213.82 vs. $221.78, P=0.05) and annual hospital admissions by 10.1% (P<0.001) compared to usual support.