Health Care Innovation Awards: Vermont

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.

HEALTH RESOURCES IN ACTION

Project Title: “New England asthma innovations collaborative”
Geographic Reach: Connecticut, Massachusetts, Rhode Island, Vermont
Funding Amount: $4,040,657
Estimated 3-Year Savings: $4,100,000

Summary: 

The "New England Asthma Innovation Collaborative” (NEAIC) is a multi-state, multi-sector partnership convened by the Asthma Regional Council of New England (ARC), a program of Health Resources in Action (HRiA), that includes health care providers, payers, and policy makers aimed at creating an innovative Asthma Marketplace in New England that will increase the supply and demand for high-quality, cost-effective health care services delivered to Medicaid children with severe asthma. Our goal is to create a sustainable infrastructure that robustly delivers evidence-based cost-effective asthma care to New England children with severe disease, and creates viable Medicaid reimbursement mechanisms to support these programs over the long-term. The targeted population is high-cost Medicaid and CHIP pediatric patients (2 – 17 years), with a focus on those with uncontrolled symptoms that have a history of using expensive urgent care. NEAIC includes following components:
1. Workforce development:  NEAIC will: a) sponsor Asthma Training to increase the number of well qualified cost-effective providers, including certified asthma educators (AE-Cs) and community health works (CHWs) with a specialty in asthma; and b) explore CHW asthma credentialing program that payers and provider practices across NE have requested and can benefit from. All of this will contribute to higher quality and culturally competent care, and we believe will help to support innovative Medicaid reimbursement as a result of demonstrated cost-effective outcomes.
2. Rapid service delivery expansion for over 1300 high-risk children with asthma in Connecticut, Rhode Island, Massachusetts, and Vermont. NEAIC employs the following components of care: 1) Asthma self-management education 2) Home environmental assessment with the provision of minor-to-moderate environmental intervention supplies to reduce asthma triggers; and 3) Use of non-physician providers shown to be cost-effective deliverers of this level of care, particularly community health workers (CHWs) and certified asthma educators (AE-Cs).  
3. Committed Medicaid payers in several New England states will work to sustain these programs by piloting reimbursement methodologies with the service providers, should the service model results demonstrate the goals of delivering better health, improving care and lowering costs..
4. A Payer and Provider Learning Community across all six New England states to rapidly disseminate demonstrated improvements to the quality and cost of asthma care, share viable reimbursement systems developed, successfully incorporate CHWs into the asthma care team, and disseminate best practices. The Learning Community builds on ARC’s existing networks and partnerships across the region, and is meant to increase awareness about these successful models with the goal of broader adoption across New England.  

NEAIC’s components build in continuous quality improvement measures through rigorous data collection/analysis, strong partnerships, and commitments from interested payers and policy makers. The establishment and promotion of CHWs as strong health care delivery partners addressing environmental conditions as part and parcel of the disease management program, with reimbursement by payers, make this an innovative model for broad dissemination and potential for replication across the nation.

TRUSTEES OF DARTMOUTH COLLEGE

Project Title: “Engaging patients through shared decision making: using patient and family activators to meet the triple aim”
Geographic Reach: California, Colorado, Idaho, Iowa, Maine, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Oregon, Texas, Utah, Vermont, Washington
Funding Amount: $26,172,439
Estimated 3-Year Savings: $63,798,577

Summary:

The High Value Healthcare Collaborative (HVHC) received an award led by The Trustees of Dartmouth College to implement patient engagement and shared decision making processes and tools across its 15 member organizations for patients considering hip, knee, or spine surgery and complex patients with diabetes or congestive heart failure. The program will hire and train 48 health coaches across the 15 member organizations to engage patients and their families in their health care and health decisions.

High Value Healthcare Collaborative (HVHC) is implementing a bundle of services related to the care of sepsis patients across 13 health care systems around the country. The overall goal of this project is to utilize process improvement strategies to implement specific services at 3- and 6-hours post diagnosis as defined by the Surviving Sepsis Campaign (SSC) and National Quality Forum (NQF) guidelines for the care of severe sepsis or septic shock. Over three years, this intervention aims to improve optimal adherence to sepsis bundled care by 5%, reduce the burden of chronic morbidity from sepsis-associated chronic organ dysfunction, and achieve a 5% relative rate reduction in the number of patients with sepsis requiring long-term acute care or sub-acute nursing care after an incident episode of severe sepsis.

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