Personalized preventive care reduces healthcare expenditures among Medicare Advantage beneficiaries.

OBJECTIVES: To investigate the impact on healthcare expenditure and utilization trends of a personalized preventive care program designed to deliver individualized care focused on disease preventionamong Medicare Advantage beneficiaries. STUDY DESIGN: MD-Value in Prevention (MDVIP) consists of a network of affiliated primary care physicians who utilize a model of healthcare delivery based on an augmented physician-patient relationship and focused on personalized preventive healthcare. The cost-effectiveness of the program was estimated using medical and pharmacy claims data relative to nonmembers. METHODS: Multivariate modeling was used to control for demographic, socioeconomic, supply of healthcare services, and health status differences between members and nonmembers. Healthcare expenditure and utilization trends for members and nonmembers were tracked from the pre-period prior to member enrollment for a period of 2 years post enrollment. RESULTS: MDVIP members experienced significantly reduced utilization rates for emergency department visits and inpatient admissions. Reduced medical utilization resulted in program savings of $86.68 per member per month (PMPM) in year 1 and $47.03 PMPM in year 2 compared with nonmembers. CONCLUSIONS: A primary care model based on an augmented physician-patient relationship and focused on personalized preventive medicine can reduce Medicare Advantage healthcare spending.

Personalized preventive care leads to significant reductions in hospital utilization.

OBJECTIVES: To assess the impact of the MDVIP model of personalized preventive care on hospital utilization rates over a 5-year period. STUDY DESIGN: This study was a comparative hospital utilization analysis between MDVIP members and nonmembers using the Intellimed database from 5 mandatory reporting states (New York, Florida, Virginia, Arizona, and Nevada) from 2006 to 2010. METHODS: Hospital discharge rates per 1000 persons were calculated and comparisons were made between members and nonmembers by age (Medicare [>65 years] vs non-Medicare [35-64 years]) and year. RESULTS: Overall, MDVIP members were approximately 42%, 47%, 54%, 58%, and 62% less likely to be hospitalized relative to nonmembers for the years 2006, 2007, 2008, 2009, and 2010, respectively. By 2010, MDVIP hospital discharges for the Medicare population were 79% lower than the nonmember Medicare population, and this difference was shown to be trending up since 2006 (70% to 79%). A similar trend was seen in the non- Medicare population (49% to 72%). In addition, elective, non-elective, emergent, urgent, avoidable, and unavoidable admissions were all lower in the MDVIP members compared with nonmembers for each year. CONCLUSIONS: The MDVIP model of personalized preventive care allows the physician to take a more proactive, rather than reactive, approach; we believe this increased physician interaction is the reason for the lower hospital utilization and ultimately lower healthcare costs seen here.