Ochsner Health
Method / Calculation / Examples
Members of a Medicare Advantage plan, a Medicare Shared Savings Program (MSSP) Accountable Care Organization, and an employer’s health plan were invited to join the Ochsner Digital Medicine chronic disease program. Members who had health insurance claims for diabetes and/or high blood pressure were invited. Members who had both conditions were tracked in the condition that they first enrolled under. A total of 529 members with diabetes enrolled and 2,915 members with high blood pressure in the digital program; the comparison (control) diabetes group had a total of 5,544 members and the hypertension control group had 15,400 members. Participants were matched to non-participants using age, gender, race, other health conditions, HCC interactions, prospective risk score, and race. Participants’ total medical costs for the first year of the program were compared to those of matched non-participants. Data came from their insurance claims, electronic medical records, and surveys. The insurance claims provided data for emergency department visits, hospital admissions, inpatient days, and office visits. The electronic medical record provided data on blood glucose control and blood pressure control.
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