According to a case study
by The Commonwealth Fund, after an initial investment by its partners of $1.6 million to build the infrastructure of what eventually became Hennepin Health, the ACO has saved money each year. In fact, medical costs have decreased by roughly 11% per year since 2012.
As part of Hennepin Health’s shared savings model, it distributes a portion of the savings to each of its partners based on their respective involvement in members’ care and completion of performance benchmarks.
Per the Commonwealth Fund case study, after distribution, over 2013, 2014, and 2015, the organization had about $3 million left to reinvest into the program. These reinvestments include hiring additional community health workers, hiring a part-time psychiatrist, and other initiatives. As a result of the program, ED visits decreased by 9.1% between 2012 and 2013, and outpatient visits increased by 3.3%. According to a Hennepin Health report, members who had been placed in housing were admitted to a hospital 16% less often, visited the ED 35% less often, visited the psychiatric ED 18% less often, and received outpatient clinic visits 21% more often between 2012 and mid-2014.
Additionally, a recent Health Affairs study of Hennepin Health sought to assess the correlation between individuals who are high-cost, high-need healthcare users and those who are also frequent users of other social services.
The authors found that over three-quarters of Hennepin Health’s Medicaid beneficiaries who are high utilizers (defined here as those with at least four emergency department visits or at least three inpatient hospital stays per twelve months of Medicaid enrollment), were diagnosed at least once with mental illness, substance use disorder, or both.
Additionally, 96.7% of high utilizers used human services at some point during the study period, compared to roughly three-quarters of the other enrollees. 94.5% of high utilizers used food support services, and about 70% used general assistance income support. Further, high utilizers accounted for expenses over four times higher than those of other enrollees in terms of per capita direct public spending. In all, the study points to the fact that a coordinated, integrated approach to addressing social determinants may help to improve outcomes.