Evaluating the Effectiveness of Care Interventions for At-Risk Populations

Our member is an Accountable Care Organization (ACO) in the midwest that unites over 1,000 employed and independent providers across the region to join forces with the overall hospital system. The ACO promotes collaboration in order to best treat patients and improve outcomes.

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The ACO had faced historic challenges with its high cost Congestive Heart Failure (CHF) population and launched a program with a goal of better serving this population in terms of outcomes metrics, while also aiming to reduce costs. Specifically, the program assigned care managers to over 200 individual patients to support their health journey – which included directing them to the most appropriate resources, guiding them in taking the proper preventative measures, and ultimately, helping reduce spending. However, as with many interventions, the ACO found it challenging to determine and accountably assess what “success” looks like.

How CareJourney Helped

CareJourney worked with the ACO to devise a two-part analysis approach. First, the ACO identified the patients touched by the intervention, then CareJourney tracked spend at regular intervals across their time in the intervention program (further described below). The next wave of analysis plans to tackle more qualitative outcomes-based measures to further drive the intervention strategy.


Thus far, the ACO has seen a downward trend in spending for patients enrolled in their program. In one slice of data, this amounted to a reduction of almost $8,000 average total patient spend just 12 months after the intervention. Additionally, the organization has been able to identify care managers who are most successful at the intervention, as well as patient personas who have responded the strongest. This analysis has provided integral information to determine if the intervention was a helpful place to invest the ACO’s regularly vied for resources. Furthermore, it has provided direction on how to tweak the intervention to maximize impact.

$8,000 reduction in average total patient spend


“CareJourney analysis helped us evaluate the effectiveness and ROI of our Congestive Heart Failure intervention program across both quality and cost metrics. It also helped us better match the right care coordinators with the patients that would benefit most from such interventions.”