Health Care Innovation Awards: Hawaii

Notes and Disclaimers:

• Projects shown may have also operated in other states (see the Geographic Reach)
• Descriptions and project data (e.g. gross savings estimates, population served, etc.) are 3 year estimates provided by each organization and are based on budget submissions required by the Health Care Innovation Awards application process.
• While all projects were expected to produce cost savings beyond the 3 year grant award, some may not achieve net cost savings until after the initial 3-year period due to start-up-costs, change in care patterns and intervention effect on health status.

FIRSTVITALS HEALTH AND WELLNESS INC.

Project Title: “Improving the health and care of low-income diabetics at reduced costs”
Geographic Reach: Hawaii
Funding Amount: $3,999,713
Estimated 3-Year Savings: $4,829,955

Summary: FirstVitals Health and Wellness Inc., in partnership with AlohaCare, received an award to implement and test a care coordination and health information technology plan that will better regulate glucose levels for Medicaid-eligible patients with Type 1 and Type 2 diabetes who have the complication of peripheral neuropathy. FirstVitals will create a secured database that will receive data feeds from a combination of wireless glucose meters and tablets, which are expected to improve health education and social networking around diabetes management issues. The "real time" information will be available to integrated care coordinators, patients, physicians and other approved caregivers, informing decisions about care and enabling caregivers to track and monitor glucose levels, improve medication adherence, and increase patient safety and the effectiveness of treatment. The project will reduce foot ulcers and amputations and attendant complications, and reduce emergency room visits and hospitalizations. Over a three-year period, FirstVitals’ program will involve and educate dozens of healthcare workers, train an estimated 11 to 12 healthcare coordinators and will create an estimated 7 to 9 jobs. The new workforce will include integrated care coordinators both clinical and non-clinical, a clinical diabetes educator, and a medical director.

ST. FRANCIS HEALTHCARE FOUNDATION OF HAWAII

Project Title: “Preventing hospitalizations in very high-risk patients”
Geographic Reach: Hawaii
Funding Amount: $5,299,706
Estimated 3-Year Savings: $10,393,944

Summary: Home Outreach Program & E-health (H.O.P.E.), supported by St. Francis Healthcare Foundation of Hawaii, received a Health Care Innovation Award from the Center of Medicaid and Medicare Services in June 2012. This initiative addresses healthcare costs associated with both hospitalizations and <30-day readmissions, with the goal of improving patient outcomes and reducing healthcare spending. The program consists of two high-risk groups: outpatients with complex health care needs identified by an algorithm and patients discharged from hospitals with the diagnosis of congestive heart failure, pneumonia, or acute myocardial infarction.  In the first group, Prevention of 1-Year Hospitalization, the emphasis will be on changing behavior, using home telehealth equipment with nurse clinician oversight as a reinforcing tool for patients to experience the impact of improved adherence with medications and other treatments.  In the second group, Prevent <30-Day Readmission, the focus will be on the transition to home of potentially unstable patients with the emphasis on the daily clinical measurements outlined in their physician’s plan of care and supported by nurse clinician oversight.  Data will be collected regularly to evaluate patient outcomes, patient and workforce satisfaction, and cost effectiveness of the program. The goal is to reduce preventable hospitalizations and readmissions by 40% as compared to a control group and to improve patients' health and quality of life.

UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

Project Title: "Cost-effective delivery of enhanced home caregiver training”
Geographic Reach: Arkansas, California, Hawaii, Texas
Funding Amount: $3,615,818
Estimated 3-Year Savings: $1,286,251

Summary: The University of Arkansas for Medical Sciences received an award for enhanced training of both family caregivers and the direct-care workforce in order to improve care for elderly patients requiring long-term care services, including Medicare beneficiaries qualifying for home healthcare services and Medicaid beneficiaries who receive homemaker and personal care assistant services. Inadequate training of the direct care worker has been shown to have a direct impact on the quality of care to the elderly. By enhancing the training of the direct-care workforce, the increasingly complex care needs of the older adult can be better managed in the home, leading to fewer avoidable hospital admissions and readmissions, better preventive care, better compliance with care, and avoidance of unnecessary institutional care. The investments made by this grant are expected to generate cost savings beyond the three year grant period. Over a three-year period, The University of Arkansas for Medical Sciences’ program will train an estimated 2,100 workers and will create an estimated four jobs. The new workforce will include a project manager, a nurse educators and an administrative assistant. Additionally, this program will train home care givers in rural areas using distance education. Through tuition and textbook support in the form of microcredit loans, this program will increase the number of certified caregivers providing direct care to elderly adults.

UNIVERSITY OF HAWAII AT HILO

Project Title: "Pharm2Pharm, a formal hospital pharmacist to community pharmacist collaboration”
Geographic Reach: Hawaii
Funding Amount: $14,346,043
Estimated 3-Year Savings: $27,114,939

Summary: The University of Hawaii at Hilo has received an award to implement Pharm2Pharm, a care transition and coordination model designed to improve patient safety and reduce medication-related hospitalizations and emergency room visits. This formal hospital pharmacist-to-community pharmacist collaboration (called “pharmacist-to-pharmacist” or “Pharm2Pharm”) closes gaps in care as patients transition from hospital to community settings.  This model has been implemented in all three rural counties of Hawaii, where physician shortages are particularly severe. The result will be better care transitions, a reduction in adverse events, improved medication adherence, and better-informed, more patient-centered decisions about medication therapies, leading to reduced hospitalizations, readmissions, and emergency room visits and better health care and health for the patients served.

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