Advocate Health Care in 2014 launched two programs to improve patient nutrition, leading to reduced patient stays, lower readmission rates—and more than $4.8 million in savings, according to new research published in American Health & Drug Benefits.
According to Advocate and Abbott Nutrition—which funded the study—prior research shows that about 33 percent of patients are malnourished or at risk of malnutrition when they enter a hospital for care, which can undercut recovery, and increase the risk of falls, infections, and readmissions. Overall, according to researchers, "the annual total direct and indirect costs of disease-associated malnutrition are between $147 billion and $157.7 billion nationally, with $15.5 billion in direct costs alone."
Advocate's programs in practice
Advocate between October 2014 and April 2015 enrolled 1,269 adults at risk of malnutrition in two Quality Improvement Programs at four of the health system's hospitals in Chicago.
Under the program, Advocate screened patients for malnutrition. Patients identified being malnourished were then given nutrition supplements in addition to their normal hospital meals and educated about the importance of adhering to their supplement regimen. The program also provided patients with post-discharge nutrition services, including coupons and follow-up phone calls.
For the study, researchers used a web-based budget impact model to determine potential cost savings from reduced readmission rates and shorter hospital stays by comparing data on program participants with data on a control group of patients treated before the programs were implemented. According to a 2016 study, the programs were associated with a 27 percent reduction in 30-day readmission rates and a nearly two-day reduction in average length of a hospital stay.
Based on those avoided readmissions and shortened hospital stays, the researchers in the latest study calculated that the programs saved Advocate between $1,499 and $3,858 per program participant. Overall, the health system saved more than $4.8 million, the researchers said.
In an announcement, Advocate EVP and CMO Lee Sacks said programs like the nutrition pilots enable health care providers to take full advantage of value-based care.
"Value-based care means looking comprehensively at patient care to identify gaps and opportunities for improvement," he said. "The study's findings demonstrate that modest changes in the way we care for patients, such as ensuring patients are nourished during their hospital stay, can have a big impact in reducing costs and improving health outcomes" (Minemyer, Fierce Healthcare, 8/10; Sulo et al., American Health & Drug Benefits, July 2017; Paavola, Becker's Hospital CFO Report, 8/11; Jones Sanborn, Healthcare Finance News, 8/10).
What providers can do now to address food insecurity
Nearly 15 percent of individuals in the U.S. live in food insecure households. Given the prevalence of the problem and the clear link between hunger, food insecurity, obesity, and other poor health outcomes, providers are uniquely positioned to provide targeted support to patients to address these challenges.
This presentation provides actionable insights for hospitals and clinics seeking ways to identify patients in need of supplemental food assistance and provide services as part of the traditional patient care plan.