OAK Street Initiative Founder Dr. Kevin Baumlin co-authors a first-of-its-kind study that shows specialized geriatric care can reduce healthcare costs up to $3,200 per Medicare beneficiary
FOR IMMEDIATE RELEASE, PHILADELPHIA – March 1, 2021 – A new study, published today in JAMA Network Open™, finds that implementing geriatric emergency departments (GED) programs with specialized staff focused on transitional care for older adults results in improved outcomes for older patients and can lower Medicare expenditures up to $3,200 per beneficiary.
More than 20 million people 65 years and older present to emergency departments each year in the United States. Roughly one third of those patients are admitted to the hospital often because they cannot be safely discharged to their home. Hospitalizations come with increased risk of falls, infection, delirium and death for older patients as well as increased costs to patients, providers and payers. According to the Center for Medicare & Medicaid Services (CMS), the average cost of an inpatient hospital stay is more than $13,800 per Medicare beneficiary.
The GED programs in the study are staffed by specially trained nurses and/or social workers who perform comprehensive geriatric, emergency care-specific assessments to older adults who present in the emergency department. Treatment is initiated based on the needs revealed during the assessment and allows nurses and social workers to connect patients with necessary resources such as home care, therapies or medical equipment. GED programs have been shown to improve clinical outcomes for patients, reduce hospitalizations, length of stay and readmissions; all factors which impact the cost of care.
Per beneficiary, savings ranged up to $2,905 after 30 days and up to $3,202 after 60 days compared to those who did not receive care through a GED program. The study is the first to quantify the potential cost savings of geriatric emergency department programs. The study authors believe the cost savings result from the change in health care utilization and trajectory of the patients.
“The findings of this study show we can reduce health care costs while improving care for some of our most vulnerable patients; older adults” said Kevin M. Baumlin, MD, study Author and Co-Investigator. Dr Baumlin is Co-Founder of OAK Street Initiative, a non-profit organization created to address Pennsylvania's most pressing problems, including improved care for older adults. He is also a Professor and Vice Chair of Emergency Medicine at Perelman School of Medicine, and Chair of Emergency Medicine at Pennsylvania Hospital.
The study data were collected from nearly 25,000 Medicare fee-for-service beneficiaries treated at Northwestern Memorial Hospital in Chicago and Mount Sinai Medical Center in New York beginning in January 2013. The study found a significant reduction in total costs of care when beneficiaries were seen by either a transitional care nurse and/or social worker trained to deliver geriatric emergency care.
“This study is the culmination of work called the “Geriatric Emergency Department Innovations in care through Workforce, Informatics, and Structural Enhancements'' (GEDI WISE) program that was funded from a $12.7 million grant from the Center for Medicare and Medicaid Innovation (CMMI) in 2012,” said Dr. Baumlin.
Currently, geriatric emergency care programs are not reimbursed by any health care payers, although previous studies have found positive associations of GED programs with clinical outcomes, including decreased hospitalizations, intensive care admissions, 30-day readmissions and cost. Dr. Baumlin notes he and his study co-investigators hope their findings serve as a framework that may be used when calculating the bundled value and potential reimbursement per patient for GED care programs by CMS and other payers.
In 2018, the first GED accreditation program was created by the American College of Emergency Physicians (ACEP) to recognize hospitals for higher levels of geriatric emergency care and to improve and standardize emergency care for the nation’s older adults. Today, more than 200 hospitals worldwide have achieved Geriatric Emergency Department Accreditation (GEDA). Accreditation is given at three levels and is adaptable based on a hospital’s needs and resources.
Pennsylvania Hospital and the Hospital of the University of Pennsylvania Emergency Department were recently recognized for GEDA accreditation.
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Press Contact: Jill Horner
jill@groundworkstrategies.org
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