A two-year study of a representative sample of participants was designed to evaluate the effectiveness of the Better Prepared Comprehensive Case Management (BPCCM) program.  Study results show documented reductions in medical expenses and in the severity of chronic conditions, as well as return on investment savings.  Study results are as follows:

· After adjusting for severity, health care expenses per participant decreased 33% after one year of program participation, while non-participant expenses increased 29%.
· Program participants reduced the severity of their chronic conditions by 46% after one year of program participation, while the severity of non-participants’ conditions increased by 12%.
· Additionally, upon program implementation, participants had chronic conditions 2.71 times more severe than non-participants.
· Return on investment was calculated at $1.30 for every dollar invested in the program.

Note:  BPCCM savings is computed by comparing the difference in one year of data collected before program implementation and one year of data collected after implementation.  Return on investment is calculated by comparing one year of BPCCM program savings to one year of program cost.

Study Summary

The two-year study period covers one-year before the implementation of the BPCCM program and one-year after implementation (see attached graphs).

Data relating to BPCCM were collected on three groups of individuals over this two-year time period:

1)  Targeted but not participated
2)  Participated
3)  Remaining covered lives

A methodology was taken that applied a Clinical Complex Index (CCI) system to individual patients.  The CCI uses both inpatient and outpatient claims information to make complexity assignments.  The index has three clinical components that recognize important differences between patient illness levels:

1)  Relative Case Complexity which reflects the clinical differences between diseases (e.g.   pneumonia is worse than an upper respiratory infection).
2)  Severity-of-illness which reflects the clinical differences within diseases (e.g. a diabetic with chronic renal failure is sicker than one without complications).
3)  Co-morbidity which acknowledges the existence of clinically interacting diseases in a single patient (e.g. combination of congestive heart failure and emphysema in a single patient).