In addition, the speed of eQHealth’s expansion is limited by
its nonprofit status, Curtis said. Basically, the company is
not allowed to raise money.
That restriction prevented eQHealth from bidding on a
contract with Georgia earlier this year, Curtis said. The contract
basically required the company to put up $10 million,
which would have taken all of its working capital.
On the positive side, eQHealth doesn’t pay taxes on the
money it makes, so it can plow everything in excess of revenue
and expenses back into the business, Curtis said.
The other major limitation is that eQHealth has a finite
number of workers and time available.
“We have a cadre of talented people, and we can grab a
certain amount of work and then we have to wrestle it to
the ground,” Curtis said.
Still, the company’s strategy has allowed it to successfully
secure a good percentage of the state and federal contracts
it pursues, Curtis said. This year the company looked at
roughly 30 potential contracts, made proposals on eight and
won four of them.
Curtis said he considers three things in pursuing a contract:
■ Does the project offer the chance to work on a part
of the health-care system he knows is broken?
■ Are there known solutions to the problem?
■ If the fix is made, will it affect costs?
Curtis said most of the efforts being made now to fix health
care at the national level are affecting insurance — who
insures whom and for what.
“It doesn’t do much to actually restructure the health-care
system in a way that improves quality at the same time it
drives down cost,” Curtis said. “I think it’s urgent that we
find things that not only improve quality but in a very direct
way can show a return on investment.”
Curtis points to the Care Transitions Project as an example
of that.
eQHealth worked with local hospitals and providers to
slash the number of seniors readmitted to hospitals from
around 19 percent to 5 percent.* eQHealth officials estimate
the program, if implemented nationwide, could save
Medicare around $12 billion a year.
Curtis said the hospital discharge planning process is typically
pretty flawed.
Although the hospital staff does its best to explain to a
patient the warning signs of a chronic condition, such as
congestive heart failure, many times the patient has a hard
time understanding, Curtis said. The result is that patients
often have a hard time explaining what’s going on to their
doctor’s office and rather than wait a few weeks for an appointment,
they end up in the emergency room and back in
the hospital.
The Care Transitions program coaches patients during the
discharge process, teaching them how to manage their care
and how to get the help they need should a problem arise,
Curtis said.
* LHCR reports that only four patients have been readmitted to the hospital
within 30 days of discharge within the group of 93 hospital patients
who were coached in the Care Transitions Project thru May 31st, 2009.
This represents a 4.3 percent readmission rate.
Results are preliminary and it is not intended that the reader should
assume that the information is official or final. The results are subject
to change as additional patients enter the project. Final results will be
published at the completion of the three-year pilot.
CMS Program Progress Report, baseline measurement period 10/07
– 03/08; unadjusted readmission rate for Acute Myocardial Infarction
20.9%, Congestive Heart Failure 22.4%, and Pneumonia 18.9%.
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