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NY practice gets its just dessert
Oxford Health Plan, an independent practice association (IPA) in White Plains, NY, implemented a simple nutrition screening and intervention program that delivered a more than 500% return on its investment.
The IPA screened its Medicare members in the mid-1990s using the DETERMINE checklist developed by the Washington, DC-based Nutrition Screening Initiative.
The initial screening effort found that 22% were at high nutritional risk and another 30% were at moderate nutrition risk. (The DETERMINE checklist appears on p. 63. See also related stories on nutritional screening on pp. 61 and 64.)
The health promotion department mailed at-risk members nutritional information, or directed them to appropriate community resources, based on their levels of need.
Members found at risk were managed through both clinical and nonclinical interventions. Oxford developed a structured benefit for a nutrition visit with a contracted registered dietician.
However, most of the at-risk Oxford members were helped by simply tapping into underused community services such as Meals-On-Wheels and Congregate Meals.
The IPA’s outreach department used a tracking form to evaluate whether or not the intervention goals were met for the high-risk members, which programs or interventions members used, and the impact of nutrition on health outcomes.
For a cost of only 21 cents per member per month, Oxford experienced a post-intervention decrease in the number of claims, claim dollars, and emergency department visits in its Medicare members that resulted in an overall 538% return on its investment.
Nutrition screening and appropriate nutrition interventions are now a routine practice at Oxford.