Practice transformation: Early impact of OCM on hospital admissions.

Abstract

30 Background: The purpose of the Oncology Care Model is to improve quality and reduce cost through practice transformation. A foundational tenant is to reduce avoidable ER visits and hospitalizations. In anticipation of being an OCM participant, we instituted a multidimensional campaign designed to meet these objectives. Methods: Prior Actions: Established phone triage unit. After-hours and weekend call. Instituted weekend urgent care. Year One: Improved education provided by nurse navigators and APPs prior to start of treatment (OCM Treatment Planning visit). Implemented triage pathways: 38 symptom and 27 follow-up pathways (modified COME HOME, Barbara McAneny, M.D.). Proactive symptoms follow-up calls to help circumvent emergent admissions. Increased APP staffing to provide blocked time slots for same day patient visits w/o schedule disruptions. Initiated “Call Us Early – Call Us First” campaign. Incorporated verbal and/or written instructions at all patient touch points, emphasizing patient’s responsibility to call before going to the emergency room. Results: Based on data from the Chronic Condition Warehouse, as provided by CMS, we were successful at reducing the acute care admissions rate by 16 percent. Conclusions: By implementing a cost efficient, reproducible, and scalable campaign targeting ER avoidance and hospitalizations, we were able to decrease hospital admissions. Reported Medicare savings amounted to nearly $798,000 in inpatient cost per quarter over 1,600 patients.[Table: see text]