Innovation in Pediatric Healthcare Delivery Utah Regional - - PowerPoint PPT Presentation

Innovation in Pediatric Healthcare Delivery

Utah Regional Healthcare Innovation Day April 27, 2016

Comprehensive Care for Children with Complex Medical Conditions

N Murphy MD E Clark MD Department of Pediatrics University of Utah School of Medicine

63.8% 25.2% 9.9% 0.99% 0.11% 24.0% 12.8% 29.8% 20.6% 12.8% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Proportions of Children & Expenditures Children Expenditures

Child Health Expenditures

top 118 with chronic dx next top 1,059 with chronic dx next top 10,595 with chronic dx .with >=1 chronic dx .with no chronic dx

63.2% of costs 11.0%

Models of Sub-Specialty Care

Primary Care Provider

Subspecialist

Primary Care Provider Master Clinician Care Team Sub-specialist

Master Clinician Team

• Case Managers
• Pediatrician/Med Ped/PMR/PNP
• Social Worker
• Dietician
• Psychology
• Clinical Pharmacist
• Rehab/Education Specialists

Modular Clinics and Master Clinician Site

Master Clinician Team

Mobile Neurology Team Modular Clinic Team Mobile Diabetes Team

Schools

Community Services Mobile Gastro Team

Rehab Programs Home Care Hospitalists

10 20 30 40 50 60 70 80 90 100 110 2009.01 2009.03 2009.05 2009.07 2009.09 2009.11 2010.01 2010.03 2010.05 2010.07 2010.09 2010.11 2011.01 2011.03 2011.05 2011.07 2011.09 2011.11 2012.01 2012.03 2012.05 2012.07 2012.09 2012.11 2013.01 2013.03 2013.05 2013.07 2013.09 2013.11 2014.01 2014.03 2014.05 2014.07

Year Month

# of CCP Enrolled Patients per Month (January 2009 - July 2014)

Distribution of Patients by Trach Vent and Deceased Status

76% 14% 7% 3% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Non Trach Vent Trach Vent Non Trach Vent, Deceased Trach Vent, Deceased

% of Total (N=568)

• 8% of Non-Trach Vent Patients (N=473) were deceased
• 16% of Trach Vent Patients (N=95) were deceased

Average # of ED Visits per Month

1 2 3 4 5 6 7 1 2 3 4 5 6 7

Average # of ED Visits per Month (CCP) Average # of ED Visits per Month (Pre CCP)

Average ED Visits per Month (CCP) Reference Line (ED Visits per Month) Linear (Average ED Visits per Month (CCP))

Average LOS Hours per Month

200 400 600 800 1,000 1,200 1,400 1,600 200 400 600 800 1,000 1,200 1,400 1,600

Average LOS Hours per Month (CCP) Average LOS Hrs per Month (Pre CCP)

Average LOS per Month (CCP) Reference Line (LOS Hrs per Month) Linear (Average LOS per Month (CCP))

Average Cost per Month

$- $100,000 $200,000 $300,000 $400,000 $500,000 $600,000 $- $100,000 $200,000 $300,000 $400,000 $500,000 $600,000

Average Cost per Month (CCP) Average Cost per Month (Pre CCP)

Average Cost per Month (CCP) Reference Line (Cost per Month) Linear (Average Cost per Month (CCP))

Estimated Cost Impact for Patients >=1 years at CCP enrollment

Expected Change in Cost per Month Median # of Months in CCP Expected Cost Impact per Patient # of Patients Total Cost Impact Non-Trach Vent

• $5,620

20

• $112,400

433

• $48,669,200

Non-Trach Vent, Deceased $9,818 12 $117,816 40 $4,712,640 Trach Vent

• $21,319

41

• $874,079

80

• $69,926,320

Trach Vent, Deceased

• $5,881

32

• $118,192

15

• $2,822,880

Total Cost Impact

• $116,705,760

Total Cost Impact per Year*

• $16,672,251

*Total Cost Impact/(7 years)