Guided Care Model Might Lower Health Care Costs

In primary care program, costs may be less for older patients with multiple chronic illnesses
By Eric Metcalf
HealthDay Reporter

MONDAY, Aug. 10 (HealthDay News) -- Guided Care, a team-driven model in primary care, could help lead to lower health care costs in older, chronically ill patients, according to preliminary research published in the August issue of the American Journal of Managed Care.

Bruce Leff, M.D., of Johns Hopkins University in Baltimore, and colleagues analyzed data from 904 patients ages 65 years and older with multiple chronic conditions, who were randomized to receive usual care or Guided Care. Guided Care is provided by a registered nurse teamed with physicians, with the nurse conducting a home assessment, coordinating other providers' efforts, and providing other services.

After eight months, the researchers found that Guided Care patients showed trends toward having fewer hospital days, nursing facility days, emergency department visits, and home health care episodes, but more specialist visits. This resulted in annual net savings of $1,364 per patient, though these findings should be interpreted with caution given the short length of the study's elapsed time, the authors warn.

"We hypothesize that as the Guided Care nurses, physicians, patients, and family caregivers become increasingly familiar with Guided Care, the reductions in the use and cost of health services observed during the first eight months will become more pronounced," the authors conclude. "We present these preliminary findings now to help inform the many decisions that will be made in the next few years regarding the transformation of chronic care in the United States."

Leff is a co-investigator on the Guided Care grant.

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