Boston hospital improves care for sickest

Massachusetts General Hospital and its associated physicians were recognized for their work in improving care for the sickest elderly, officials say. The National Patient Safety Foundation presented its Socius Award to Dr. Tim Ferris, medical director of Massachusetts General Physicians Organization; Dr. Eric Weil; and Melissa Vespa, program care manager at the Patient Safety Congress in Washington. The hospital was honored for a program, enacted in conjunction with the Centers for Medicare and Medicaid Services, to raise the level of care given to patients with multiple chronic illnesses via the use of nurse case managers. The three-year demonstration project was selected by CMS in 2005 to test ideas for caring for the sickest 15 percent of Medicare patients, who account for more than 75 percent of the nation's healthcare costs. Begun in 2006, the program initially enrolled 2,500 high-risk patients who were assigned case managers who assessed patient needs, collaborated with physicians to develop treatment plans, educated patients about options for medical treatment and support services, facilitated patient access to services and supported patient self-management of medical conditions. Hospitalization rates, emergency room visits and mortality rates were statistically significantly lower for patients in the pilot program than the control group. Patients reported higher satisfaction rates in regard to discussions and communication with the healthcare team, and improved physical functioning. An independent review found substantial, statistically significant reductions in the cost of care -- savings to the Medicare program of $2.65 for every $1 spent on the Care Management Program for the program's first three years -- and a $3.35 return on investment for every $1 spent in the first 24 months of the renewal period.