Changing The health experience locally

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 Our Community Care Team supports patients and providers using innovative health care solutions to deliver whole health care in the communities we serve.

33% reduction in inpatient admissions

15% reduction in Emergency Department visits

54% reduction in potentially preventable readmissions

6% below expected cost PMPM

Results in the first 9 months showed:

Savings of approximately $2,158 PMPM
Estimated savings of $1.9  million annually
Reduction >50% on 30-day Readmission rates for transitional care patients

Source: Jackson, C. Medicare Cost Savings Attributable to Care Management. 12.6.17

10.4.19 Press Release: $5.3 Million In Savings

Quality Score 95.12%, 2018 10% reduction in hospitalizations, 5% reduction ED utilization
Reduced Ave. Cost of Care by $282 per beneficiary

National ave. $180/ben for physician led, $27/ben for hospital-led

Care Management For Seniors:

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November 2022 Metrics showing a 2% decrease in A1C, 11% decrease in BMI, and 3% decreases in both SBP and DBP as well as increases in Advance Care Directives and enrollment in community resources, increase in hypertension control, increase in screening for nephropathy and reducing elevated A1Cs