Patients with complex needs are typically the biggest utilizers of high-cost care. It’s well understood that the sickest 5 percent of the population account for 60 percent of health care costs. That’s why the Better Health Partnership led an initiative with providers, insurance companies and community organizations to develop Red Carpet Care, a patient-centered coordinated care program that provided an advanced level of care to deliver greater value for patients and payers.
With grant support from the Robert Wood Johnson Foundation, Better Health Partnership helped the MetroHealth System establish Red Carpet Care clinics within two of its Family Medicine practices in December 2012. Each was staffed by a dedicated nurse care coordinator who organized patients’ care and addressed acute care needs. All 130 patients invited to participate had ties to MetroHealth and insurance coverage with Medical Mutual of Ohio, a commercial insurer, or Buckeye Community Health Plan, a Medicaid managed care plan. The insurance companies provided financial support for the care coordinators and agreed to share savings that were realized from patients’ reduced use of costly health care services.
Red Carpet Care enrollees also benefited from community partners – West Side Catholic Center and University Settlement – which helped patients with a variety of human services. Every week, the care coordinators, insurers’ case managers and representatives of the community organizations met to discuss enrollee challenges to better use their collective resources to overcome them.
The program delivered estimated savings of $317,000 over one year of continuous enrollment for the 67 participating enrollees of Medical Mutual of Ohio. In addition, Red Carpet Care enrollees generally did better on quality measures for diabetes and high blood pressure than a group of similar patients who were not in the program. Compelling evidence of success also was clear in the stories that Red Carpet Care participants recently shared about the program’s impact on their lives. Compelling evidence of success was clear in the stories that Red Carpet Care participants shared about the program’s impact on their lives at a graduation party.