Indiana Health Plan Reduces Readmissions 66 Percent And Saves Up To $6.5M Annually With ZeOmega's Population Health Management Solution

Jiva Population Health Management Solution Gives MDwise Real-Time Data to Streamline Collaboration, Create Patient-Centered Care Plans

ZeOmega Inc., recently announced that its Jiva population health management solution has helped Indiana’s largest not-for-profit health plan — MDwise — reduce readmission rates by 66 percent and lengths of stay by 61 percent, while achieving a potential annual savings of $6.5M as part of a special initiative.

According to MDwise, a significant number of its members were seeking skilled nursing-level of care at a network of statewide skilled nursing facilities (SNFs). While the stays were generally short-term (less than 30 days), they resulted in more readmissions and emergency department visits, so MDwise and the SNFs joined forces to devise a solution.

“When we noticed the trend, we got together to ask how we could improve the transition of care, make it work better for our members, and decrease readmissions,” said Dr. Caroline Carney, chief medical officer of MDwise.

MDwise and the SNFs developed a strategy to optimize average lengths of stay and prevent readmissions by enhancing concurrent review, case management, and care transition programs. They relied heavily on MDwise’s existing Jiva platform and its advanced, bi-directional communication capabilities. While Jiva enhanced collaboration between stakeholders on patient-centered care plans, it also helped ensure seamless transitions between various service points.

Having access to more complete information and the ability to communicate in real-time has led to more informed decision making, streamlined the care process, and made a critical difference for both MDwise and the SNFs.

“We now have one continuous plan of care, on one single platform,” said Dr. Carney. “It brings care management and pharmacy data into the SNFs before patients arrive, which has been a key factor in helping us make significant progress on our goals.”

Through Jiva, the SNFs work with MDwise to discharge members within their benefit limitations, instead of “flipping” them to traditional Medicaid programs. The SNFs now notify MDwise when mutual patients are admitted and discharged, enabling MDwise’s case and disease management staff to following up with them. These same staff members also furnish the SNFs with up to four months of patient pharmacy data upon notification of an admission. Hospitals involved in the process have less work to do in identifying facilities for patients because the SNF network is willing to accept them. Overall, the positive experience with MDwise has led the SNFs to begin accepting members from MDwise’s other lines of business as well.

All told, the initiative has generated a 61 percent reduction in lengths of stay, which, using the state of Indiana’s daily average cost of stay from 2010, could translate to $6.5M in annual savings to MDwise; and readmissions have been reduced by 66 percent.

“MDwise’s experience shows how Jiva helps organizations achieve their goals and produce meaningful and measurable results,” said Nandini Rangaswamy, ZeOmega’s executive vice president and chief strategy officer. “It underscores how healthcare organizations can rely on Jiva’s flexibility and adaptability to facilitate success beyond traditional workflows. We’re delighted that Jiva has played such a crucial role in MDwise’s special initiative.”

To read the entire case study on how MDwise reduced readmission rates and lengths of stay by more than 60 percent while saving $6.5M annually, visit http://www.zeomega.com/mdwise-case-study-snfs.

About MDwise
MDwise is Indiana’s only nonprofit health insurance company focused on giving uninsured and underserved Hoosiers the compassionate service and care they want and need. MDwise’s services are currently provided to more than 300,000 members in partnership with over 1,400 primary medical providers and a statewide array of specialists, hospitals and other providers. In addition, MDwise is a Qualified Health Plan issuer in the Health Insurance Marketplace. MDwise’s services offer a coordinated, comprehensive approach to managing the cost and utilization of Indiana’s health care services. For more information, visit www.MDwise.org.

About ZeOmega
ZeOmega’s powerful population health management platform delivers high-value, strategic solutions enabling payers and care-delivery organizations to improve individual health and provider performance. With deep domain expertise and a comprehensive understanding of complex population health challenges, ZeOmega serves as a “true-north” partner for clients—offering flexible deployment and delivery models that leverage an innovative platform designed to integrate workflow, analytics, content and communication capabilities. By consistently meeting customer expectations and project benchmarks, ZeOmega has earned a sterling reputation in the industry for responsiveness and reliability. For more information, visit www.zeomega.com.