Survey tool delivers ROI for disease management program

A University of Oregon study on disease management patients who were coached using a survey tool called the Patient Activation Measure showed significant improvements in clinical outcomes, fewer hospitalizations and ER visits and cost savings over patients who received traditional telephonic coaching.

The Patient Activation Measure, or PAM, group saw a 33 percent decline in hospital admissions compared to the flat rate experienced by the control group. The PAM group also saw a 22 percent decline in ER visits, whereas the control room experienced a 20 percent increase.

The study, published in The American Journal of Managed Care, calculated that the use of PAM translated into a savings of $145 per member per month (PMPM) because of fewer hospital stays, and $11 PMPM savings for the reduced ER visits.

Judith Hibbard, PhD, and her colleagues at the University of Oregon, developed the self-assessment tool to determine an individual’s confidence, knowledge and skills needed to successfully manage his or her own health and healthcare across four “activation levels.” Hibbard said coaching was tailored according to the patient’s activation level.

The study’s findings are bolstered by another pilot using the PAM. The Washington State Aging and Disability Services Administration’s Chronic Care Management Program for Medicaid patients resulted in $109 PMPMreduction in medical expenditures.

“We’re encouraged with the Medicaid results,” said Chris Delaney, CEO of Insignia Health, which markets the tool. “The idea is resonating: Can you render care more efficiently?”

With healthcare organizations dealing with challenged budgets in these difficult economic times, the ability to reshape those dollars is important, Delaney said.

The study shows that the tool can consistently and precisely measure how well members are doing, link tailored coaching to outcomes important to the industry, drive change and finally activate individuals across levels, said Hibbard.

LifeMasters, a disease management provider, tested the tool in a 2005 pilot and provided the control and treatment groups for the study.

“The ‘huge take home’ from the study is that you can move somebody in the way you coach,” said Mary Jane Osmick, MD, vice president and medical director for LifeMasters. “We have to continue to show success to get everybody on board.”