Abstract Details

Title Multiple Sclerosis Patient’s Health Care Utilization Influenced by MS Wellness Shared Medical Appointments – A Single Center Experience

Topic Multiple Sclerosis

Presentation(s) P15 - Poster Session 15 (12:00 PM-1:00 PM)

Poster/Presentation
Number 9-007

Objective To examine multiple sclerosis (MS) patients’ healthcare utilization pre and post MS wellness shared medical appointments (SMAs).

Background SMAs combine medical care and patient education and have been shown to improve patient outcomes in various medical conditions while increasing system capacity and reducing costs.

Design/Methods We conducted a retrospective chart review of all patients who participated in a pilot MS wellness SMA program at our center. Data were collected 1 year prior to and following a SMA and included demographics, clinical data, patient-reported outcomes and healthcare utilization. Pre/post SMA data were compared using Wilcoxon rank sum test.

Results 50 patients (age 50.1±12.3 years, 94% female and 80% relapsing remitting MS) attended at least one wellness SMA. The majority had private insurance (50%) with 28% and 20% having Medicaid and Medicare, respectively. The most common comorbidities were depression and anxiety (44%). Attending a SMA decreased the number of emergency room visits (n= 13 to n=2, p=0.0005) and hospital admissions (n=7 to n=1, p<0.0001) avoiding the substantial cost associated with those encounters. Follow-up visits with primary care providers (n=19 to n=41, p=3.47 e-10), physical therapists (n=15 to n=27, p=0.004) and psychologists (n=6 to n=19, p=0.003) increased for the entire cohort of attendees. The patients utilizing acute care settings still had a significant cost savings even after accounting for the additional post-SMA visits due to the lower cost of those out-patient visits.

Conclusions Our pilot MS wellness SMA improved health care utilization while also reducing overall cost. There was increased, low-cost, high value care usage with patients’ primary care provider, physical therapist and psychologist. This utilization was accompanied by a reduced usage of high cost, acute care settings such as emergency room visits. SMAs may be an effective way to enhance low cost, high value health care utilization for MS patients.

Authors/Disclosures
Justin Abbatemarco, MD PRESENTER	Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech . Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics, Inc.. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. The institution of Dr. Abbatemarco has received research support from Amgen.
Jeffrey A. Cohen, MD (Cleveland Clinic)	Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Convelo. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria. Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viatris. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PSI. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celltrion.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Mary R. Rensel, MD, F�鶹��ýӳ��	Dr. Rensel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for genentech. Dr. Rensel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG. Dr. Rensel has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Rensel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for TG. Dr. Rensel has stock in Brain Fresh LLC . The institution of Dr. Rensel has received research support from NMSS. The institution of Dr. Rensel has received research support from Roche- Genentech . The institution of Dr. Rensel has received research support from Biogen.

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