E-mail this page				Print this page

Contact: Mercer Feedback

United States
New York, 23 October 2009

A just-completed pilot project sponsored by the Boeing Company shows that re-engineering primary health care for the chronically ill can both improve the quality of care and reduce the total cost of care, according to an article posted today by the policy journal Health Affairs.

The article can be directly accessed here.

Athored by Mercer’s chief physician, Arnold Milstein MD, along with Pranav Kothari MD, and Rushika Fernandopulle MD, both affiliated with Harvard Medical School, and Theresa Helle, who is with the Boeing Company, the article outlines a Boeing-sponsored pilot program, called the Intensive Outpatient Care Program (IOCP). The pilot sought to improve care for the costliest quintile of Boeing’s Puget Sound adult employees and their dependents participating in the company’s non-HMO plans.

The program tested a new chronic care model, the ambulatory intensive caring unit (A-ICU). Its development was led by Mercer with funding from the California HealthCare Foundation. Patients who enrolled in the Boeing pilot were connected to an IOCP care team that included a dedicated in-person RN care manager and participating primary care physicians who worked with the patients to implement a mutually agreed-upon clinical improvement plan.

The plan was executed through intensive in-person, telephonic and e-mail contacts, including frequent proactive outreach by an RN, and education in self-management of chronic conditions. The program also included rapid access to care coordinated by the IOCP team, daily team huddles to plan patient interactions, and direct involvement of specialists in primary care contacts, including behavioral health, when feasible.

Total cost of care was measured for 276 chronically ill enrollees in the Boeing pilot program compared to 276 carefully matched patients who served as a control group. Total annual per capita health care spending per participating patient was reduced by 20 percent compared to the control group. 

Multiple quality measures and clinical outcomes showed improvement compared to baseline for the pilot project patients. Physical functioning scores improved 14.8 percent, mental functioning scores improved 16.1 percent, and patients who said they received care “as soon as needed” improved 17.6 percent.  Patient-reported missed work days declined 56.5 percent.

The A-ICU design was led by Dr. Arnold Milstein who coordinated a Mercer-selected design team of national experts in primary care design. Team participants and peer reviewers included Tom Bodenheimer MD, University of California San Francisco, Jennie Chin-Hansen RN, now Board Chairman of AARP, Richard Baron MD, Chair of the American Board of Internal Medicine Foundation, Rushika Fernandopulle MD, Harvard Medical School, Chuck Kilo MD, of Greenfield Health and Molly Coye MD, who previously headed Medicaid in New Jersey and California.

The pilot project description may be viewed online at www.healthaffairs.org.

About Mercer

Mercer is a leading global provider of consulting, outsourcing and investment services. Mercer works with clients to solve their most complex benefit and human capital issues, designing and helping manage health, retirement and other benefits. It is a leader in benefit outsourcing. Mercer’s investment services include investment consulting and multi-manager investment management. Mercer’s 18,000 employees are based in more than 40 countries. The company is a wholly owned subsidiary of Marsh & McLennan Companies, Inc., which lists its stock (ticker symbol: MMC) on the New York, Chicago and London stock exchanges.

For more information, visit www.mercer.com.

E-mail this page

Print this page

Contact: Mercer Feedback