P0533 - A Virtual Integrated Care Program Improves Patient Outcomes, Engagement, and Satisfaction at Reduced Costs: A Prospective Trial

Award: Presidential Poster Award

Sameer K. Berry, MD, MBA¹, Jeffrey Berinstein, MD, MSc², David J. Cook, MD³, Michael Lahm, BA⁴, Walter W. Chan, MD, MPH⁵, John I. Allen, MD, MBA⁶, William D. Chey, MD^6
1New York Gastroenterology Associates, New York, NY; ²University of Michigan Hospital, Ann Arbor, MI; ³Mayo Foundation for Medical Education and Research, Rochester, MN; ⁴Optum, Eden Prairie, MN; ⁵Brigham and Women's Hospital, Boston, MA; ⁶University of Michigan, Ann Arbor, MI

Introduction: Disorders of gut-brain interaction (DGBI) are characterized by chronic gastrointestinal (GI) symptoms without structural abnormalities. DGBIs affect > 20% of the United States population, costing over $30 billion annually. Despite the high prevalence, only 10–25% of patients with GI symptoms seek care, in part related to poor access to timely, high-quality care. This highlights the need for innovative multidisciplinary care models in partnership with traditional clinic-based GI care to address the unmet needs of these complex patients.

Methods: We performed a prospective, single-arm clinical trial with 1:5 propensity-score matched controls to evaluate the effectiveness of a virtual integrated-care program on clinical outcomes, patient satisfaction, and costs in patients with DGBIs as well as patients with GI symptoms without a formal DGBI diagnosis. Analyses was performed using a GI visit as the index date for the control group and enrollment in the virtual integrated-care program for the intervention group. Cost and utilization analyses were performed by Optum Labs (United Healthcare Group) using their claims database. Difference-in-differences analysis was used to evaluate changes in all-cause and GI-related cost over time between study groups.

Results: Among 234 participants enrolled in the virtual integrated-care program, 83% remained engaged, 98% reported satisfaction, 92% reported symptom improvement, along with 1.3 fewer missed workdays reported over 6 months. After 6 months, patients enrolled in the virtual integrated-care program had significantly lower GI-related costs ($3,934 vs. $9,047, p< 0.0001) and all-cause costs ($9,843 vs $17,573, p=0.0033) compared to propensity-matched controls (Figure 1). Difference-in-difference analyses demonstrated GI-related cost-savings of $6,723 (p< 0.0001) and all-cause savings of $10,292 (p=0.00076). These savings were driven predominantly by significant reduction in avoidable GI-related ED visits (8% vs 21%, p< 0.0001), GI-related imaging (20% vs 47%, p< 0.001), endoscopy (15% vs 68%, p < 0.0001), and all-cause ED visits (20% vs 28%, p=0.0087). These cost savings and reduction in avoidable utilization were sustained at 9 months.

Discussion: A virtual integrated-care program in partnership with traditional GI practices resulted in high patient engagement, satisfaction, symptom improvement, reduced healthcare utilization, and statistically significant cost-savings for patients with DGBIs compared to propensity-matched controls.


Disclosures:


Sameer K. Berry, MD, MBA¹, Jeffrey Berinstein, MD, MSc², David J. Cook, MD³, Michael Lahm, BA⁴, Walter W. Chan, MD, MPH⁵, John I. Allen, MD, MBA⁶, William D. Chey, MD⁶. P0533 - A Virtual Integrated Care Program Improves Patient Outcomes, Engagement, and Satisfaction at Reduced Costs: A Prospective Trial, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.