San Diego Project Incredibly Successful
May. 19, 2015
DENVER, Col., May 19, 2015 – One of the nation’s leading experts on the delivery of health care called San Diego’s Project Health Improvement Initiative an “incredibly successful” program that could serve as a national model.
The program was funded by a $1.1 million Healthcare Innovation Grant awarded in June of 2012 by the federal Centers for Medicare and Medicaid Services.
The goals of the three-year grant were to reduce the cost of low-income, chronically ill “super utilizers” to the health care system and to improve the patients’ long-term outcomes.
The Center for State Health Policy at Rutgers University, the grant’s administrator, assembled the four award winners annually to share information. They met in Denver for a third and final time last week to swap stories, data and plans for the future after the grant ends in June.
Based upon initial data, San Diego project leaders reported that they had saved an estimated $5 million in healthcare costs of 160 patients over the three years, a Return on Investment (ROI) calculation of 5 to 1, while dramatically improving the lives of most of them.
And they announced that they had formed a non-profit organization, the Multicultural Health Foundation, to build on that success.
The heart of that success is a business model that reinvests a portion of the healthcare savings achieved back into the project not only to sustain it but to expand efforts to prevent chronic diseases in San Diego County’s multicultural communities.
Joel C. Cantor, who directs the Rutgers Center, said San Diego’s project was “incredibly successful in integrating a new model of care in the ways things get done in California.”
He said San Diego was able to take the lessons learned from a grant-funded demonstration project and convert it to a program “that appears to be very sustainable and add value to the healthcare system and to the patients.”
Cantor has researched the delivery of health care for 37 years, including serving in director positions at the Robert Wood Johnson Foundation and the United Hospital Fund of New York.
He cited the San Diego project’s two significant accomplishments. The first was to adapt the “super-utilizer” model to the way health care is delivered and paid for in California, being “really sensitive” to the financial incentives of all the groups involved in the health care of the patients.
Secondly, he said, the project made providers consider the social determinants that affect health outcomes, such as patients’ lack of adequate housing and transportation.
“The San Diego model breaks the old mold of thinking about health care as visits and prescriptions and days of stays” in hospitals, he said. “It looks at the whole patient and their entire life and that leaves people better off and I think it’s more efficient.”
The grant that funded the project was awarded to the MultiCultural Medical Group, an association of about 300 independent physicians from 25 countries specializing in meeting the needs of African American, Latino, Asian and Middle Eastern patients in San Diego County.
The fact that the San Diego project accomplished this “in a for-profit, doctors’ office-setting, where most care is delivered in this country, is really a tremendous accomplishment,” he said. “And I think a real model for other settings.”
The director noted that in California, super-utilizers generate high costs that are avoidable with a comparatively modest investment by payers and comprehensive coordination of the patients’ health care.
“So there’s a clear business case for payers” to support the San Diego model, he said.
“I think there’s potential for a real legacy of better care and lower cost,” he concluded, “which is very gratifying for us.”