Circ: New economic tool helps discern best HF intervention program
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Previously, little standardization existed among costing methods of patient-focused interventions (i.e., cardiac rehab, disease management interventions, among others). Due to this fact, the team at Duke developed the Tools for Economic Analysis of Patient Management Intervention in Heart Failure (TEAM-HF) Costing Tool to demonstrate the value of patient-centered healthcare interventions. The results appeared in the Dec. 6 issue of Circulation: Cardiovascular Quality and Outcomes.
Budgeting for these types of programs is one piece of the puzzle, but how much value it adds to the healthcare system is another. With this tool, healthcare managers can better negotiate appropriate payments and understand how much it costs to deliver these types of services, Shelby D. Reed, PhD, of the Duke Clinical Research Institute at the Duke University School of Medicine in Durham, N.C., said in an interview.
The TEAM-HF program is two-fold: First, it is a tool to estimate costs for patient-focused interventions; second, it consists of a computer model to estimate long-term cost-effectiveness of patient-focused interventions in heart failure. While most previous studies have focused on personnel costs involved in these types of programs, the current tool can estimate the true costs of delivering an interventional program.
“Discovering how much it costs to deliver disease management programs was the first step,” Reed said. “If we can evaluate what the outcomes are for these types of programs, in cases where there is true value added from these programs, healthcare managers can then start to negotiate appropriate payments with payors or appropriate operating budgeting with hospital administrators.”
The tool, a user-friendly spreadsheet program, facilitates the systematic identification of patient-centered healthcare interventions. “The tool goes back to the first principles of economics and works from the ground up to identify the resources required to deliver an interventional program,” Reed noted.
With the tool in place, facilitates are able to enter site-specific costs and aggregate a side-by-side comparison to other programs. “Programs in large metropolitan areas would probably face higher costs,” Reed said. “Now, they can compare their own program costs to the national average based on the standardized costs put forth in the tool.
“Up to this point it has been almost impossible to compare costs across published papers of different programs because of the different costing methods used and different unit prices used,” Reed noted. “The current tool is a way to try to systematically estimate costs to facilitate comparisons.”
The tool incorporates facility costs, equipment costs, supply costs, start-up costs and total costs.
“Healthcare resources are limited and we want to ensure that we are using those resources in the most efficient manner,” Reed said. “Knowing what it truly costs to deliver these types of patient programs and their outcomes, we can identify which programs are actually benefiting the patients most.”
Once interventions are found, nurses and providers will be able to demonstrate the value of the programs and take the results to hospital administrators to better budget for and deliver these medical programs.
“The tool is intended to weed out the best programs so we are delivering those to patients, and this will help healthcare managers re-engineer their programs so they are the most efficient and reach the most number of patients.”
During the study, the researchers tested the tool on a previously reported trial, HF-ACTION, which was an exercise training program for patients with HF.