Sutter Health Launches Innovative Advanced Care Program in Stanislaus, San Joaquin, and Merced counties

Posted on Aug 28, 2013 in Quality, Scroll Images

Advanced Illness Management (AIM)® Reduces Hospitalizations, Health Care Costs

Caregiver holding hand of patient

Even with a history of cervical cancer and heart problems, 92-year-old Enes Cereni of South San Francisco says she enjoys time with her husband of 63 years and their children, grandchildren and great-grandchildren thanks to Sutter Health’s Advanced Illness Management (AIM)® program, which launched in El Dorado, Placer, Solano, Sonoma and San Mateo counties recently, as well as in the East Bay Region and in San Francisco. Beginning today, patients in the Sutter Central Valley Region service area with late-stage chronic illness can access the same resources and support available to Mrs. Cerini through AIM’s next major expansion in Northern California. The expansion extends access to eligible Memorial Medical Center, Memorial Hospital Los Banos, Sutter Tracy Community Hospital, Sutter Gould Medical Foundation, Sutter Care at Home and Central Valley Medical Group patients in portions of Stanislaus, San Joaquin, and Merced counties.

The AIM program provides nurse-led care management, palliative care, and advance care planning for patients with late-stage chronic illness. With a pilot program in Sutter Health’s Sacramento Sierra Region showing positive outcomes, the Center for Medicare & Medicaid Innovation (CMMI) awarded Sutter Health a three-year, $13 million Health Care Innovation Award to support the expansion of AIM throughout Northern California.

“AIM uses a nurse-led interdisciplinary team to bridge the gaps between the hospital, the community physician’s office, and home for our sickest patients,” said Brad Stuart, M.D., senior medical director for Sutter Care at Home, an affiliate of Sutter Health. “Quality, affordable care for all of our patients is a priority and the expansion of AIM systemwide complements our mission and values. AIM supports giving the right care, at the right time, at the right level of care for the patient’s goals.”

Sutter Health’s pilot program showed reduced hospitalizations and improved care transitions, contributing to an improved quality of life for patients enrolled in AIM. The success of the pilot program was crucial to Sutter Health receiving the CMMI grant. Since 2010, the pilot AIM program:

  • Reported a 75 percent reduction in ICU days, an average decrease of one or more days for hospital stays, and more than 50 percent reduction in hospitalizations at 90 days post-enrollment.
  • Showed high patient and family satisfaction (4.7 out of 5).
  • Reduced costs for payers by $5,000 per patient at 90 days post-enrollment.

“Before AIM, I had a choice of calling 911 and that’s it, and I’d end up in the hospital,” said 81-year-old AIM patient Edward Fogarty of Rocklin. “I don’t want to go to the E.R. What AIM gives me is that I can call someone besides 911, and they give me advice and counsel, which really helps.”

For more information about AIM, visit http://www.sutterhealth.org/quality/focus/advanced-illness-management.html.

The project described was supported by Funding Opportunity Number 1C1CMS331005-01-00 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

 

Posted by on Aug 28, 2013 in Quality, Scroll Images | Comments Off on Sutter Health Launches Innovative Advanced Care Program in Stanislaus, San Joaquin, and Merced counties