Breakfast

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Jeffrey Brenner Slides/LDI Presentation - LDI Health Economist

You are cordially invited to the first

Camden City Healthcare Providers’

Breakfast

Join fellow clinicians to get acquainted, and to share strategies, resources, and

ideas on providing health care to Camden City residents.

Thursday, January 24, 2002

7:30 – 9:00 am

At the Rutgers University Octagon Room,

Camden Campus Center, North Third Street

Sponsored by the Center for Strategic Urban Community Leadership at

Rutgers University, Division of Urban Health in the Department of Family

Medicine at Cooper Hospital, and the Camden Area Health Education Center

Please RSVP to Daria Chacón at 856-963-2432 x218 by Friday, January 11.


!"#$%&$'(#)*%+'!#),!

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7898!:!7899

Trenton Housing Authority

237 Oakland St

1,354 episodes

Providence Nursing & Rehabilitation Center

439 Bellevue Ave

1,174 episodes

Rowan Tower

620 W State St

1,065 episodes

Luther Towers

489 W State St

1,551 episodes

333 W State St

1,042 episodes

Rescue Mission of Trenton

98 Carroll St

2,315 episodes

Ewing

!

!

!

!

Trent Center West

465 Greenwood Ave

1,335 episodes

Royal Health Gate Nursing & Rehab

1314 Brunswick Ave

1,834 episodes

!

!

!

Trenton

Trenton Center Apartments

511 Greenwood Ave

1,700 episodes

8


Newark Beth Israel Hotspot Analysis (2010)

Total Costs per

Census Block (deciles)

$0

$1 - $1,097

$1,098 - $4,955

07104

07114

07105

Total Receipts by Zip Code

07112 $24,079,842

07108 $16,553,538

07103 $14,181,330

07106 $11,788,444

07104 $7,022,274

07114 $6,440,656

07107 $5,594,552

07105 $5,498,100

07102 $4,206,927

$4,956 - $10,700

$10,701 - $18,685

07107

$18,686 - $31,353

$31,354 - $54,230

$54,231 - $88,719

$88,720 - $167,531

07106

$167,532 - $1,793,955

! Hotspot

(>$200k in receipts

and >50 patients)

1060 Broad St

(1 Building)

87 Patients

198 ER & Inpatient Visits

$993 thousand in receipts

07103

07102

! !

!

07108

Elizabeth Ave

High Rises (6 Buildings)

774 Patients

1,390 ER & Inpatient Visits

$2.0 million in receipts

!

07112

!

Mt Vernon and Manor Dr

High Rises (4 Buildings)

272 Patients

379 ER & Inpatient Visits

$1.11 million in receipts

SAINT BARNABAS

HEALTH CARE SYSTEM

Newark Beth Israel Medical Center

9


Care Continuum Model!

Hospital

Admission

s Data!

• Mul.disciplinary care management outreach

• Pa.ents with history of ED visits/hospital admissions

and readmissions (4 admits w/in 6 mos.); social

complexi.es

• Average 6-­‐8 month engagement

Inclusion!

Triage!

CCHP Outreach!

High Risk

Intermediate Risk

Health Coaching

Medical Home!

Care Coordina.on

Data driven care mgt.

Pa.ent Engagement

• Nurse driven care transi.on

• Pa.ents with history of ED visits/hospital admissions

and readmissions (2+ admits w/in 6 mos.); socially

stable

• Average 6-­‐8 week engagement


A Typical Month of Healthcare in the US (New England J Med 2001; 344:2021-25)


Utilization typology

Inpatient visits, 2011

ED visits, 2011

0 1 2 3 to 4 5+

0 0 1,293 57 4 1

1 26,128 2,075 117 7 0

2 to 3 13,390 1,842 373 68 3

4 to 5 3,216 666 223 118 15

6 to 7 1,020 251 106 84 24

8 to 9 386 112 39 41 11

10 + 339 96 70 65 62


Utilization typology

Inpatient visits, 2011

ED visits, 2011

0 1 2 3 to 4 5+

0

1

Normal Range of Utilization

2 to 3

4 to 5

Potential High

Utilizers

Inpatient

High Utilizers

6 to 7

8 to 9

Emergency

Department

High Utilizers

Potential High

Utilizers

10 +


Utilization matrix

Inpatient visits, 2011

ED visits, 2011

0 1 2 3 to 4 5+

0

1

44,728 (85%) patients

5,210 Inpatient visits

63,489 ED visits

2 to 3

4 to 5

6 to 7

8 to 9

$28,000,000 (50%) IP payment

$25,800,000 (59%) ED payment

4,961(9%) patients

28,447 ED visits

$11,500,000 (27%) in

ED payment

1,563 (3%) patients

1,239 IP visits

6,962 ED visits

$6,700,000 (18%) in IP

payment

$2,800,000 (6%) in ED

payment

985 (2%) patients

1,856 IP visits

4,129 ED visits

$10,000,000 (17%) IP

payment

$1,700,000 (4%) ED

payments

503 (1%) patients

2,026 Inpatient Visits

4,144 ED Visits

$10,900,000 (20%) in IP payment

$1,700,000 (4%)in ED payment

10 +


Patient A

Es.mated 2011 Payment

ED: $38,000 to $76,000 (93 visits)

IP: $65,000 to $130,000 (12 visits)

Total: $103,000 to $206,000

Saving Es.mates

30% reduc.on in u.liza.on :

ED: -­‐28; -­‐$11,000 to -­‐$22,000

IP: -­‐ 4; -­‐$19,000 to -­‐$38,000


Train local residents to

participate in decisionmaking

over health care

resources!


Promote collaboration

among providers and

between providers and the

community!


Comparing Emergency Room High Utilizers in

Camden, Trenton, and Newark!

Emergency Department High Utilizers Top 1% 2007

Camden

Patients 386

Visits 5169

Visits/Patient 13.4

% visiting more than one hospital 80.6%

Trenton

Patients 504

Visits 7616

Visits/Patient 15.1

% visiting more than one hospital 78.2%

Newark

Patients 928

Visits 14367

Visits/Patient 15.5

% visiting more than one hospital 71.1%


SENATE, No. 2443

STATE OF NEW JERSEY

214th LEGISLATURE

INTRODUCED DECEMBER 6, 2010

Sponsored by:

Senator JOSEPH F. VITALE

District 19 (Middlesex)

SYNOPSIS

Establishes Medicaid Accountable Care Organization Demonstration Project

in DHS.

CURRENT VERSION OF TEXT

As introduced.


Lourdes ACO

Cooper ACO

Virtua ACO

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