Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers.

Sangnam Ahn,Mary Altpeter,Lindsey Post,Matthew Lee Smith,Marcia G Ory

doi:10.3389/fpubh.2015.00042

Abstract

Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP’s documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs.

Highlights

AND RATIONALE Adults with chronic conditions are the primary users of healthcare in US and account for two-thirds of total healthcare spending [1]
Coupled with our rapidly aging society, this trend, if not curtailed, will lead to one of every three dollars spent in America paying for healthcare by 2040, with at least 65% of that spending going toward patients with multiple chronic conditions [4]
When users input the appropriate values for their situation, they will be able to use this Tool to customize estimated cost savings related to reduced healthcare utilization for participants anticipated to enroll in the chronic disease self-management program (CDSMP) within the 12 months

Summary

Introduction

AND RATIONALE Adults with chronic conditions are the primary users of healthcare in US and account for two-thirds of total healthcare spending [1]. The chronic disease self-management program (CDSMP) has been introduced to help patients with chronic conditions improve their health behaviors, enhance their health outcomes, and reduce healthcare utilization [5, 6]. Topics covered in CDSMP include coping skills and symptom control [7]. Coping strategies such as action planning and feedback, behavior modeling, problemsolving techniques, and decision-making are applicable to all chronic conditions. CDSMP participants are taught how to control their symptoms through relaxation techniques, healthy eating, sleep and fatigue monitoring, medication management, exercise, and improved communication with providers.

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Conclusion