Table 1. Evaluation of Congestive Heart Failure Pilot Program |
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| GOAL | MEASURE | RESULTS | STATISTICAL SIGNFICANCE |
| PARTICIPANT QUALITY OF LIFE | |||
| Participant’s perception of quality of life will improve from enrollment through the end of the Pilot. | Living with Heart Failure Questionnaire (LHFQ) scores will decrease. | 64% of participants experienced a decrease in LHFQ scores. | Significant decrease in LHFQ score with 95% confidence. |
| Participant’s functional status will improve from enrollment through the end of the Pilot. | New York Heart Association (NYHA) classification will decrease. | 19% of participants experienced a decrease in NYHA class. | Significant decrease in functional class with 95% confidence. |
| PROVIDER DIAGNOSIS AND TREATMENT | |||
| Physicians will increase use of appropriate tests to confirm CHF diagnosis the longer they participate in the CHF Pilot. | Increase in frequency of Ejection Fraction (EF). | No change in use of EF; consistently between 30% to 40%. | None |
| Increase in appropriate use of ACE inhibitors the longer they participate in the CHF Pilot. | Increase in use of ACE inhibitors. | No change in use of ACE; consistent at about 50% of participants on ACE. | None |
| Increase in appropriate use of Calcium Channel Blockers (CCB) the longer they participate in the CHF Pilot. | Decrease in use of CCB. | No change in use of CCB; consistent at about 20% of participants on CCB. | None |
| UTILIZATION AND MEDICAL COSTS | |||
| Decrease CHF related inpatient admissions from baseline (pre-enrollment) compared to participation in the CHF Pilot. | CHF Admissions per 1000 members per year. | 29% reduction from baseline. | Significant decrease in CHF Admissions with 95% confidence. |
| Decrease CHF inpatient days from baseline (pre-enrollment) compared to participation in the CHF Pilot. | CHF Inpatient Days per 1000 members per year. | 39% decrease from baseline. | Significant decrease in CHF Inpatient Days with 95% confidence. |
| Decrease CHF related emergency visits from baseline (pre-enrollment) compared to participation in the CHF Pilot. | CHF Emergency Visits per 1000 members per year. | 18% decrease from baseline. | None |
| Decrease total medical costs from baseline (pre-enrollment) compared to participation in the CHF Pilot. | Total Costs per member per month. | 39% decrease from baseline. | Significant decrease in Total Costs with 95% confidence. |
| Decrease total CHF related medical costs from baseline (pre-enrollment) compared to participation in the CHF Pilot. | CHF Total Costs per member per month. | 58% decrease from baseline. | Significant decrease in CHF Total Costs with 95% confidence. |
| SATISFACTION AND VALUE OF PROGRAM | |||
| High participant satisfaction. | Percent of participants who rate satisfaction at 4 or 5 on a five point scale. | 89% satisfied. | Significant majority of participants, with 95% confidence. |
| High provider satisfaction. | Percent of providers who rate satisfaction at 4 or 5 on a five point scale. | 64% satisfied. | Significant majority of providers, with 95% confidence. |
| High participant value. | Percent of participants who rate the value at 4 or 5 on a five point scale. | 90% perceived as valuable. | Significant majority of participants, with 95% confidence. |
| High provider value. | Percent of providers who rate the value at 4 or 5 on a five point scale. | 36% perceived as valuable. | None |
| High participant perception of CHF Pilot achieving objectives. | Percent of participants who rate the CHF Pilot achieving it goals at 4 or 5 on a five point scale. | 83% thought Pilot met its objectives. | Significant majority of participants, with 95% confidence |
| High provider perception of CHF Pilot achieving objectives. | Percent of providers who rate the CHF Pilot achieving it goals at 4 or 5 on a five point scale. | 34% thought Pilot met its objectives. | None |
| PARTICIPANT COMPLIES WITH PHYSICIAN’S TREATMENT PLAN | |||
| Participant improves compliance with medication regimen the longer enrolled in the CHF Pilot. | Increase self-reported medication compliance. | 99-100% of participants comply with medication regimen. | None |
| Participant improves compliance with diet including restrictions on sodium intake. | Increase in self-reported diet compliance. | 92% of participants comply with diet restrictions upon enrollment, then it drops and seems to stabilize at about 80%. | None |
| Participant improves compliance with weight monitoring. | Increase in self-reported weight monitoring compliance. | 83% of participants comply with weight monitoring upon enrollment, then it drops and seems to stabilize at about 80%. | None |