A new study recently released by Avalere Health has cited the GRACE Team Care™ (Geriatric Resources for the Assessment and Care of Elders) program from Indiana University Medical Center to be among the nation’s most successful in effectively managing high-risk Medicare populations.
The Avalere study focused on ways for payers and providers to better manage the cost of high-risk Medicare beneficiaries – typically older adults with multiple chronic conditions and functional impairment. The study revealed that to be successful in this effort, health plans and physicians need to not only focus on treating a person’s medical condition but must also have strategies in place for managing a broad array of care needs across multiple settings.
In looking at best practice models, the study said that the GRACE program “not only engaged a wide variety of healthcare providers in the care transition process, but also provided appropriate care management through continuous patient education as well as health assessment, monitoring and counselling. These efforts resulted in substantial reductions in emergency department visits and hospitalizations.”
GRACE represents a fresh team approach to managing a patient’s health, which has been proven to enhance quality of geriatric care in ways that optimize health and functional status, decrease excess healthcare use, and prevent long-term nursing home placement. The catalyst for the GRACE program is its support team, headed by a nurse practitioner and a social worker who support the primary care physician in fully addressing a patient’s health conditions and achieving a patient’s goal from the comfort of their own home. The GRACE team provides patients with healthcare education; medication management; and coordination of care between specialty physicians, the emergency department, hospitals and a broad array of community support services.
The Avalere study said that enrolling members into an effective care transition or care coordination program such as GRACE “can help health plans reduce their members’ healthcare utilization and subsequently their spending.” In a model presented in the study, GRACE produced annual savings for high-risk members of nearly $4,300 while producing an ROI per year for the health plan of 95 percent.
“The GRACE team approach has been shown to deliver proven value as it relates to higher quality of life, better quality of care coordination, and lower overall healthcare cost,” said Steven Counsell, M.D., executive director, GRACE Team Care program. “We are proud that Avalere has acknowledged our program as one of the nation’s finest as we continue to look for even better ways to serve this fast-growing segment of the American population.”
First launched at Eskenazi Health in Indianapolis, today GRACE Team Care is also offered through the Medicare Advantage program of Indiana University Health Plans Inc. and is being successfully applied at several other health plans, medical groups and VA hospitals in select markets around the country. Its efficacy in smartly coordinating care for vulnerable seniors has been documented not only in the Avalere study but in recent articles in JAMA, Health Affairs, the Journal of the American Geriatrics Society and many other places. Further information on GRACE may be obtained at http://graceteamcare.indiana.edu.
Avalere Health is an advisory services company whose core purpose is to create innovative solutions to complex healthcare problems. Based in Washington, D.C., Avalere delivers research, analysis and strategy for leaders in healthcare business and policy. Its study on “Effective Management of High-Risk Medicare Population” was supported through funding from The SCAN Foundation.
