WellCare, Kentucky Homeplace Partnership Reduces Emergency Room Use
Kentucky Homeplace’s community health workers worked with WellCare members to help improve chronic disease self-management and reduce emergency room utilization.
Source: Think Stock
By - A partnership between WellCare and Kentucky Homeplace showed a reduction in emergency room utilization and cost of care.
The partnership aimed to help over 2,000 residents of rural Kentucky with chronic disease access health coaches and workshops that promoted self-management of their conditions, including asthma, diabetes, high blood pressure, and obesity.
Participants in the program came for over 30 counties across eastern Kentucky to participate in workshops the promoted preventive care and chronic disease self-management. The workshops were run by community health workers, trained through Kentucky Homeplace to advocate for access to medical, social, and environmental services for members.
"Community health workers saw a real change in members once they had the tools to improve their health and the confidence to know how to use them," said Kentucky Homeplace Director Mace Baker, RN. "No matter what challenges they were facing, this holistic approach to meeting a variety of needs equipped participants with the tools they needed to better manage their health."
Participating members were identified by WellCare, the government-sponsored managed care service provider, based on their need for additional support.
One year after the start of the pilot program, data showed a ten percent reduction in overall emergency room (ER) visits and nearly a 13 percent reduction in non-emergency ER visits.
Additionally, the results showed a 23 percent reduction in inpatient admissions and a 27 percent decline in hospital inpatient days.
WellCare estimated decreasing these utilization metrics for members with complex medical conditions was associated with a reduction in the cost of care by over 13% or $2,3000 annually.
The program consisted of 22 community health workers from Kentucky Homeplace offering 6-week health coaching workshops where participants met weekly to focus on improving nutrition, medication use, exercise, communication, and decision-making. Specific classes included diabetes management, mental health, first aid, and CPR.
Other services offered included free or reduced-costs healthcare, health literacy, food pantry assistance, and utility assistance. Participants also received gas cards as accessibility of transportation is a large issue for many residents of rural areas. Eliminating potential barriers around transportation promoted and incentivized workshop attendance.
"We know when people have trouble putting food on their tables or paying their water bill it's difficult to focus on managing their health," said Ben Orris, COO for WellCare of Kentucky. "When we can close those gaps in care — helping people get reliable transportation, healthy food and a safe place to live we can see real progress in health outcomes and lowered healthcare costs."
Further analysis showed a higher impact among members with more complex medical conditions such as diabetes and multiple chronic conditions. Participants with diabetes showed a reduction in emergency room visits by 16% and hospital admissions by 29%, associated with an overall cost reduction of $3,424 per member per year.
Individuals with diabetes and asthma showed a decrease in non-emergency ER visits by 22 percent.
The Kentucky Homeplace program is run out of the University of Kentucky’s Center of Excellence in Rural Health.
"These findings illustrate two crucial components of better healthcare. One, when people have direct education and support from a trusted healthcare provider, they can better manage their chronic conditions," said Frances Feltner, DNP, MSN, RN, FAAN, health director at the UK Center of Excellence in Rural Health. "Second, sometimes all it takes to make sure a patient makes it to an appointment is a tank of gas. When we can remove barriers like transportation, suddenly healthcare is more accessible."
