Journal of Health Economics and Outcomes Research

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Health Care Costs attributable to Hospital-diagnosed Back Pain: A Longitudinal Register-based Study of the Danish Population

Authors: Rikke Søgaard1, Jan Sørensen1

JHEOR 2014;1(3):266-75

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Generalized Propensity Score Matching with Multilevel Treatment Options

Author: Onur Baser

JHEOR 2013; 1(1):1-13

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Anti-vascular Endothelial Growth Factor Outpatient Treatment Patterns in Patients with Exudative Age-related Macular Degeneration from a Japanese Hospital Claims Database

Authors: Tomohiro Iida1, Aya Narimatsu2, Kenji Adachi2, Edward CY Wang2

JHEOR 2014;2(1):41-52

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Latest Articles

A Cost-effectiveness Analysis of Brentuximab Vedotin in Relapsed or Refractory Systemic Anaplastic Large Cell Lymphoma

Authors: Margaret Hux1†, Denise Zou1†*, Esprit Ma2, Peter Sajosi3†, Andreas Engstrom4, Ross Selby5, Eugene Benson5, Andrew Briggs6,7, Vijayveer Bonthapally3†

JHEOR 2016;4(2):188-203

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What Drives Responses to Willingness-to-pay Questions? A Methodological Inquiry in the Context of Hypertension Self-management

Authors: Billingsley Kaambwa1*, Stirling Bryan2, Emma Frew3, Emma Bray4, Sheila Greenfield5, Richard J McManus6; on behalf of the TASMINH2 Investigators**

JHEOR 2016;4(2):158-71

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Mobile Integrated Healthcare: Preliminary Experience and Impact Analysis with a Medicare Advantage Population

Authors: Daniel J. Castillo1, J. Brent Myers1, Jonathan Mocko1, Eric H. Beck2

JHEOR 2016;4(2):172-87

Affiliations: 1Evolution Health, Dallas, TX, USA; 2Envision Healthcare, Greenwood Village, CO, USA


Background: Mobile Integrated Healthcare (MIH) is a novel, patient-centered approach to population
management. This concept creates a needs-matched, time appropriate assignment of one or more members
of a multi-professional clinical team to care for patients on a scheduled or unscheduled basis. The selection
of the site of care for scheduled interventions is driven by patient choice and, most often occurs in the
patient’s home; unscheduled interventions are guided by a 5-point triage system and, based on acuity, may
be treated in the home, primary care office, urgent care or, rarely, in an emergency department.

Methods: An MIH team was assigned to deliver a care coordination program for a Medicare Advantage
PPO (MAPPO) population (55% female, 71.2 years mean age), with risk assignment and interventions
designed to affect potentially avoidable utilization of Emergency Medical Services (EMS), emergency
department, and medical inpatient admissions. Patients participating in the MIH program were compared
with contemporaneous, risk-matched non-participants as well as to actuarially expected cost and utilization
based on historical claim experience.

Results: All measured trends demonstrated favorable results for patients participating in the MIH program
when compared against a matched cohort: 19% decrease in emergency department per member per month
(PMPM) cost, 21% decrease in emergency department utilization, 37% decrease in inpatient PMPM
cost, 40% decrease inpatient utilization, all measures reached statistical significance. Member experience
satisfaction scores and patient activation measures also showed favorable preliminary trends.

Conclusions: This initial impact analysis of a MIH care coordination program for this MAPPO population
demonstrates promising trends regarding utilization, cost, member experience and patient activation. These
preliminary findings indicate both that implementation of such a program is feasible and strongly suggest
meritorious impacts upon the health, experience and cost of care for the population.

Keywords: population health, care management, community paramedic, interprofessional, value-based care, mobile integrated healthcare

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