New Data Shows Community Health Workers Significantly Reduce Hospital Readmissions and Spending

A program that uses community health workers (CHWs) to help chronically ill patients access care following hospitalization has cut readmission rates in half and reduced hospital spending by 35 percent for high-risk patients, according to new data from the University of Maryland St. Joseph Medical Center (UMSJMC) and Maxim Healthcare Services.

The program uses CHWs, frontline public health workers with a strong understanding of community resources, to help patients at high risk for hospital readmission due to medical, psychological, functional and socioeconomic complexity.

Data collected in 2017 and the first half of 2018 shows only 8 percent of program participants were readmitted to the hospital within 30 days of discharge compared with 18 percent of non-program participants. Only 23 percent of program participants returned to the hospital within 90 days post discharge compared with 34 percent of non-program participants. Over a two-year period, the reduction in readmissions represents more than $3 million in savings and a 3.8:1 return on investment.

"We continue to be very encouraged by these results," said Gail Cunningham, MD, FACEP, senior vice president and chief medical officer at UMSJMC. "The work we're doing to support patients dealing with complex medical issues and unmanaged psychological or social challenges is not only beneficial for our patients, but also for the healthcare system as a whole."

Maxim and UMSJMC also evaluated the program's financial impact by comparing per-patient hospital charges in the months before and after program enrollment. Participants continued to generate lower hospital charges after the 30-day program was complete. Per-patient charges for participants decreased by 35 percent after 30 days and by 9 percent after 90 days. At the same time, non-program participants saw pre- to post-discharge charges decrease by 4 percent after 30 days and actually increase by 12 percent at 90 days.  

Patients enrolled in the program are assigned a CHW who is specially trained to address issues such as transportation, housing, employment and access to medical services that are often barriers to care following discharge. 

"The key to the success of this program is a strong focus on the social and behavioral barriers that keep many patients from adhering to their clinical plans," said Andy Friedell, Maxim's senior vice president of strategic solutions. "Through the use of CHWs, we are able to help high-risk patients transition back to their homes without heightening their risk for readmission. The benefits of this approach come into even sharper focus when you consider that a full year of this type of community-based program is less expensive than an average 27-day stay in a skilled nursing facility and roughly half the cost of the average readmission."  

The program is just one example of the growing role providers are assuming in addressing the social determinants of health. While the U.S. still lags behind other countries spending just $0.56 on social services and support for every dollar spent on healthcare, studies show states with a higher percentage of spending on social supports see significantly better health outcomes across most common chronic health conditions.

"Health begins long before illness or injury strikes – in our homes, schools, neighborhoods and places of work," said Karen DeSalvo, senior advisor at Leavitt Partners and co-convener with Governor Mike Leavitt of the National Alliance to Impact the Social Determinants of Health. "The ability of individuals and families to lead healthy and productive lives is influenced by personal choices, as well as our experiences and the conditions in the communities where we live: the social determinants of health."

The analysis followed 1,778 patients over a three-month period who were identified during their hospitalization as being at high risk for readmission. Of that group, 840 patients enrolled in the program and used CHW services while 938 did not enroll or did not respond to outreach following discharge from UMSJMC. Data provided by Maryland's Health Information Exchange was also analyzed to establish visit and hospital charge information across all Maryland hospitals. The analysis affirms a previously released report, which showed a 65 percent reduction in readmissions in the first 16 months following the program's launch in 2015.

About University of Maryland St. Joseph Medical Center 
University of Maryland St. Joseph Medical Center (UM SJMC), which was founded in 1864 by the Sisters of St. Francis of Philadelphia, is a 218-bed nonprofit, regional medical center in Towson, Maryland and a member of the 14-hospital University of Maryland Medical System. Located in a suburban community in Baltimore County, UM SJMC has a rich history of providing loving service and compassionate care. Its Catholic heritage ever-present, the medical center today boasts a wide range of superb clinical programs and centers of excellence, including the Cancer, Heart and Orthopaedic Institutes, Women and Children's services and Emergency Medicine. For more information, visit www.umstjoseph.org.

About Maxim Healthcare Services
Maxim Healthcare Services provides a comprehensive suite of home healthcare, behavioral care, healthcare staffing, personal caregiving, and population health and wellness solutions. Our commitment to customer service, compassionate patient care and staffing experienced healthcare professionals has made a difference in the lives of patients, employees and caregivers nationwide for more than 30 years. Learn more about Maxim Healthcare Services, or get more information about available positions.