The Program Cost Effectiveness of a Safety-Net Hospital Program Expanding Social Needs Activities in Atlanta.

Abstract

The Grady Heart Failure Program (GHFP), based in a safety-net hospital, is an outpatient program that follows heart failure hospitalization. The 2018 GHFP added a community health worker, patient liaison, and mobile integrated health home visits to reduce socioeconomic barriers to treatment. Important outcomes for the GHFP included the program cost and patient follow-up visits within seven days of hospital discharge. We calculated the difference in 30-day related readmission between 2017 and 2018 to assess pre-post program effectiveness. Patient follow-up visits within seven days increased from 63.7% in 2017 to 65.6% in 2018. Related 30-day readmissions declined from 15.5% in 2017 to 13.1% in 2018. Compared with 2017, the incremental program cost per related 30-day hospital readmission averted was $7,955 in 2018. The expanded GHFP is potentially cost-saving from the perspective of the hospital-provider based on the inpatient cost saved from a heart failure readmission averted.