COST SAVINGS FOR CAPABLE PROGRAM DRIVEN BY DECREASES IN HOSPITAL AND LONG-TERM CARE FOR PARTICIPANTS

An aging population is a primary factor associated with escalating healthcare costs due to increased drug spending, chronic diseases and co-morbidities, physician visits, and hospital costs (TD Report, 2010). There has already been a marked increase in the number of Long-Term Care (LTC) residents with co-morbidities, and chronic diseases will be more prevalent in future years (Conference Board of Canada, 2011). The chapter explores the use of a rehabilitation model to improve the current decision-making processes that impact the health outcomes of seniors across the Ontario LTC continuum. Improved clinical management of this population through rehabilitation could result in not only enhanced quality of care but also significant cost savings for both the Long-Term Care (LTC) industry and the health system at large. The chapter highlights the need for the LTC sector to identify strategies for harnessing innovation to improve its own activities and outcomes and become a leader in health system transformation.

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Audit Feedback Interventions to Address High-Risk Prescriptions in Long-Term Care Homes: A Costing Study and Return on Investment Analysis

10.21203/rs.3.rs-15730/v1 ◽

2020 ◽

Author(s):

Kednapa Thavorn ◽

Srishti Kumar ◽

Catherine Reis ◽

Jonathan Lam ◽

Gail Dobell ◽

...

Keyword(s):

Return On Investment ◽

Long Term Care ◽

Cost Savings ◽

Audit And Feedback ◽

Health Staff ◽

Term Care ◽

Total Cost ◽

Intervention Cost ◽

Costing Study

Abstract Background: Audit and feedback is a common implementation strategy, but little literature describes its costs. ‘MyPractice’ is an audit and feedback initiative produced by Ontario Health, the provincial agency tasked with supporting quality of care. This study sought to estimate the costs of ‘MyPractice’ and assess whether the financial benefit of ‘MyPractice’ offsets those costs. Methods: We conducted a costing study from the perspective of the government of Ontario, which funds both Ontario Health and necessary healthcare costs for people living in long-term care (LTC) homes in the province. Total cost of ‘MyPractice’ was calculated as the sum of the costs of producing and disseminating the reports (covering three report releases) which were obtained from Ontario Health staff interviews and document reviews. Return on investment (ROI) was calculated as the ratio of net cost-savings and the intervention cost. Net cost-savings were estimated as the reduction in the costs of antipsychotics incurred by LTC home residents attributable to ‘MyPractice’ reports. Results: Total intervention costs were C$223,691 (C$838 per physician and C$74,564 per release). Costs incurred during the development phase accounted for 74% of the total cost (C$166,117), while implementation costs for three report releases were responsible for 26% of the total costs (C$57,575). The ROI for every C$1 spent on the ‘MyPractice’ intervention was 1.22 (95% CI: 0.82, 1.61) for three report releases. Conclusion: ‘My Practice’ report offers a good return on investment and the value for money increases if physicians sign up and view the reports.

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Cost savings from decreased utilization of antipsychotic drugs associated with rivastigmine use in long term care facilities

Neurobiology of Aging ◽

10.1016/s0197-4580(00)82092-8 ◽

2000 ◽

Vol 21 ◽

pp. 167

Author(s):

Patrick Mends ◽

Edward Snyder ◽

Douglas Gause ◽

John C. Messina

Keyword(s):

Antipsychotic Drugs ◽

Long Term Care ◽

Cost Savings ◽

Term Care ◽

Care Facilities

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Are Personal Budgets a Financially Sound Reform Option for the German Long-Term Care Insurance?

Jahrbücher für Nationalökonomie und Statistik ◽

10.1515/jbnst-2010-0402 ◽

2010 ◽

Vol 230 (4) ◽

Cited By ~ 2

Author(s):

Melanie Arntz ◽

Stephan L. Thomsen

Keyword(s):

Nursing Home ◽

Home Care ◽

Long Term Care ◽

Cost Savings ◽

Nursing Home Care ◽

Term Care ◽

Long Run ◽

Long Term Care Insurance ◽

The Stability

SummaryIn a long-run social experiment, personal budgets have been tested as an alternative home care program of the German long-term care insurance (LTCI). By granting the monetary value of in kind services in cash, personal budgets are considered to enable customized home care arrangements, thereby avoiding costly nursing home care and thus saving LTCI spending. However, personal budgets also compete with the already existing and less generous cash option of the LTCI. Any transition from the receipt of cash benefits to personal budgets thus challenges the view of personal budgets as a cost savings device, unless personal budgets sufficiently reduce the use of costly nursing home care to balance these extra costs.This paper therefore contrasts the short-term costs of implementing personal budgets with potential cost savings if personal budgets enhance the stability of home care and avoid costly nursing home care. For this purpose, the paper investigates the effects of personal budgets on the duration of home care until moving to a nursing home as well as the perceived stability of home care. Despite a positive effect of personal budgets on the stability of home care, LTCI spending is likely to increase in the short to medium run. In the long run, however, the expected transition to decreasing numbers of cash recipients favors the introduction of personal budgets.

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Cost Savings from Home and Community-Based Services: Arizona’s Capitated Medicaid Long-Term Care Program

Journal of Health Politics Policy and Law ◽

10.1215/03616878-22-6-1329 ◽

1997 ◽

Vol 22 (6) ◽

pp. 1329-1357 ◽

Cited By ~ 42

Author(s):

William G. Weissert ◽

Timothy Lesnick ◽

Melissa Musliner ◽

Kathleen A. Foley

Keyword(s):

Long Term Care ◽

Cost Savings ◽

Care Program ◽

Community Based ◽

Term Care ◽

Community Based Services

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Health Care Cost Savings of Providing Geriatric Gastroenterology Consultations in Long Term Care Facilities

The American Journal of Gastroenterology ◽

10.14309/00000434-201210001-01462 ◽

2012 ◽

Vol 107 ◽

pp. S583

Author(s):

Il Paik ◽

Francisco Barajas ◽

Elliot Schwartz ◽

Brenda Matti ◽

Donald Kotler

Keyword(s):

Health Care ◽

Long Term Care ◽

Health Care Cost ◽

Cost Savings ◽

Term Care ◽

Care Facilities

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2446. Longitudinal Results and Cost Savings Using a Bundle of C. difficile Infection Prevention Strategies in a Long-Term Care Facility

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2124 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S845-S846

Author(s):

Bridget A Olson ◽

Michael L Butera ◽

Noam Ship

Keyword(s):

Infection Prevention ◽

Long Term Care ◽

Care Facility ◽

Cost Savings ◽

Antibiotic Use ◽

Prevention Strategies ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility

Abstract Background Long-term care patients are at high risk of C. difficile infections (CDI) due to advanced age, high comorbid illness burden, and frequent antibiotic use. Primary infection prevention of CDI is challenging and not frequently studied. Following a period of high CDI incidence, the Long-Term Care facility at Sharp Coronado Hospital implemented a bundle of strategies. Methods Patient census, the incidence of CDI (primary and recurrent cases), transfers to acute care and length-of-stay were collected from Jul 2008 through December 2018. In the first phase, 2010, a bundle of CDI prevention strategies was initiated, including an Antimicrobial Stewardship Program (ASP), reduction of acid suppression, and L. acidophilus and S. boulardii probiotics with antibiotic use. From 2012, there was further refinement of the ASP and the probiotic was changed to capsules of a 3-species combination of Lactobacillus acidophilus CL1285, L. casei LBC80R and L. rhamnosus CLR2, 100 Billion CFU daily. In October 2016, a protocol was put in place delegating authority to pharmacists to add probiotics to all antibiotic courses. The average CDI rates were calculated and compared for each time period. The net cost of CDI was calculated from the number of CDI cases, hospital length-of-stay and probiotic purchases. Results The incidence of facility-onset CDI cases decreased significantly with each policy change from 7.6 cases/10,000 patient-days (2008–09), to 2.8 (2010–11, p = 0.028), to 0.91 (2012-Q3 2016, p = 0.0015) and to the present incidence 0.24 (Q4 2016–2018, p = 0.048). The annual cost of facility-onset CDI was $214k initially. The annual cost, including the purchase of probiotic, decreased to $161k with introduction of the bundle, to $57k in switching probiotics, and to $18k with initiation of a probiotic policy. Conclusion Implementing a bundle of concurrent infection prevention strategies resulted in a significant reduction in CDI incidence. Refinements to the bundle led to significant reductions in CDI incidence, along with switching the type of probiotic, and delegating ordering authority to pharmacists to ensure probiotic compliance. Cumulatively, there was a 95% decrease in CDI incidence at the Long-Term Care facility and meaningful cost savings with each refinement. Disclosures All authors: No reported disclosures.

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An Initial Analysis of the Effects of a Long-Term Care Insurance on Equity and Efficiency: A Case Study of Qingdao City in China

Research on Aging ◽

10.1177/0164027520907346 ◽

2020 ◽

pp. 016402752090734 ◽

Cited By ~ 1

Author(s):

Wei Yang ◽

Shuang Chang ◽

Wenbo Zhang ◽

Ruobing Wang ◽

Elias Mossialos ◽

...

Keyword(s):

Long Term Care ◽

Financial Burden ◽

Cost Savings ◽

Initial Assessment ◽

Term Care ◽

Equity And Efficiency ◽

Qingdao City ◽

Insurance Model

Finding a suitable mechanism to finance long-term care (LTC) is a pressing policy concern for many countries. Using Qingdao city in China as a case study, this article presents an initial assessment of a newly piloted LTC insurance by evaluating its effects on equity and efficiency in financing. Drawing data from 47 in-depth interviews conducted in 2016, this study found that there remain sizable disparities in financial burden among insurance participants, despite an emphasis on ensuring equitable access to care. Although the insurance brought cost savings to the health care sector, the LTC providers are incentivized to provide care at the least cost, even when such care is deemed inadequate due to the fixed payment for their services. This article offers critical insights into the potentials and challenges of applying the LTC insurance model in a developing country, where critical lessons can be drawn for public LTC insurance in other countries.

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