Neighborhood Health Plan of Rhode Island touts savings of home-care program for Medicaid's 'frequent utilizers'

May 25, 2015

Neighborhood Health Plan of Rhode Island is touting early success in its program to address Medicaid subscribers with frequent and hefty medical bills. Aware that 7% of the Medicaid enrollees in the state account for two-thirds of spending, the insurer identified 450 of its "frequent utilizers" and formed caregiver teams to visit patients at their homes with the aim of reducing visits to the hospital. The Health@Home program's early success has led Neighborhood to predict savings of at least $2.7 million in its first year, while chief medical officer Dr. Francisco Trilla expects total savings to be much greater. The caregiver teams are made up of one nurse practitioner, a social worker and two community health workers, are supported by a doctor, a pharmacist and a social worker, and are paid by Neighborhood on a per patient, not per service rendered, basis. Data indicate that, compared to the previous year, patients are going to the emergency room 26% less often, while the number of days they are spending as admitted patients at the hospital has dropped 30%.