Title: Sickle Cell Center for Adults
Organizations: Johns Hopkins, Amerigroup, Priority Partners MCO
Innovation type: Community Based Chronic Disease Management
What They’re Doing: Providing comprehensive care for patients with Sickle Cell Disease supported by Per Member Per Month Fees
Clinical Innovation: The Sickle Cell Center for Adults at Johns Hopkins offers an interdisciplinary, team-based approach to care that integrates hematology, social work, psychiatry, home visits by community health workers , non-clinical support services such as transportation, and primary care for patients with Sickle Cell Disease. A key component of this program is an outpatient Sickle Cell Infusion Center that is open 7 days a week and offers rapid access to infusion therapy treatment to address patients’ pain management needs . The Infusion center provides patients with specialized care and serves as an alternative to the Emergency Department.
Amerigroup and Priority Partners have teams of case managers that help coordinate care for their members with Sickle Cell Disease. The case managers conduct outreach to members and connect them with the Center, facilitate care coordination between the Center and the members’ other healthcare providers, and offer transportation.
Financing Mechanism: Two Managed Care Organizations (MCO) (Amerigroup and Priority Partners) pay a Per Member Per Month fee to cover expenses associated with the comprehensive care (care coordination, case management) the Sickle Cell Center provides to their members. The MCO’s continue to pay for all healthcare services the Center provides to members using the traditional fee for service model of payment.
Evaluation Type: Quasi-Experimental .
Evaluation Plan: Evaluating the impact of the Infusion center on rates of hospitalizations for sickle cell patients across the city of Baltimore. Measures include time spent in the Infusion Center, hospitalization rates from the Infusion Clinic compared to the default treatment at Emergency Department and hospital 30 day readmission rates. Planning a patient satisfaction survey.
Patient Health and Cost Outcomes:
Reduced Admissions: After the opening of the Infusion Center in 2008, there was a reduction in hospitalizations for patients with sickle cell disease across all hospitals in the city of Baltimore. In the first quarter of 2009, Hopkins saw an increase of 29 more hospitalizations yet there were 60 fewer discharges across the city of Baltimore (as compared to the first quarter in 2008). This trend continued in the second quarter of 2009 when there were 32 fewer hospitalizations across the city of Baltimore compared to the second quarter in 2008. (Hopkins again saw an increase of 20 more hospitalizations.)
Since the SCIC opened on weekends at the beginning of May 2011, the percent of admissions from the ED on weekends has dropped to approximately 22-26%. Prior to the opening of the Sickle Cell Infusion Center on weekends the percent of sickle cell patients admitted was 38-50%, with an average of 50%.
The percent of sickle cell patients admitted from the ED on weekends prior to the opening of the Sickle Cell Infusion Center on weekends was between 38-50%, with the average of 50%. Since the SCIC opened on weekends at the beginning of May 2011 the percent of admissions from the ED on weekends has dropped to between 22-26%.
Reduced Readmissions: When compared to the University Health System Consortium (UHC) data for the top six hospitals based on volume, the JHH readmission rates and average length of stay are significantly lower. In FY 2010 the JHH readmission rate was 23.95% compared to a range of 30.34 to 50.53% for the comparison hospitals.
Other data of interest:
Target Population: Adults with Sickle Cell Disease who live in the greater metropolitan Baltimore and Washington, D.C. areas
Date of Implementation: Sickle Cell Program started in 2002, The Infusion Center opened in February, 2008
Contact: Sophie Lanzkron MD, MHS, Johns Hopkins, firstname.lastname@example.org or Dr. Andrew Bergman, email@example.com , 410-981-4016
Where to learn more: http://www.hopkinsmedicine.org/hematology/sickle_cell/