Catastrophic case management system
Franklin Health in Upper Saddle River, NJ, and the Health Care Information Agency (HCIA) in Baltimore have announced plans to jointly develop an information system designed specifically to measure the financial and clinical impact of intensive, team-supported, patient-centered decision-making on medically complex cases.
While only 1% of all patients treated by the health care system are classifiable as complex, they account for nearly 30% of total U.S. medical expenditures. The catastrophic case management tool would be patterned after Franklin’s approach to these cases.
The agreement follows a year of analysis and testing of Franklin’s managed care cases that revealed an 11% reduction in cost for complex cases, including complex cancers, HIV/AIDS, and liver and kidney disease. Average, annual savings per case managed by Franklin was estimated at $20,000. Multiplied by the estimated 1.9 million such cases each year, the program represents a potential savings of $38.7 billion.
Under the agreement, the companies will apply the clinical and financial profiles of complex cases developed during HCIA’s analysis of several million covered lives tracked across all treatment settings and included in HCIA’s array of comparative and benchmark patient data warehouses. These profiles will be used on an ongoing basis to benchmark the performance of Franklin’s program for its self-insured employer and managed care clients.
For more information, contact David Levy, MD, Chairman and CEO of Franklin Health, (201) 512-7057. Or call HCIA, (410) 576-9600.
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