Cost Savings through HEP for Caregivers

The following is a literature review of the article “The Impact of a Caregiver Health Education Program on Health Care Costs” by Ronald W. Toseland and Tamara L. Smith of State University of New York at Albany. The study originally appeared in Research on Social Work Practice, volume 16 issue 1, in January 2006.

Researchers conducted a study to determine whether providing counseling and support groups for caregivers would reduce overall health care costs for both caregivers and elderly patients receiving care. Previous studies showed that providing support for caregivers prolonged their ability to care for their elderly loved ones. The basis for the study was the understanding that caregiving can wear down caregivers both emotionally and physically. This support was to be provided through health education programs (HEP) to both the caregiver and the care recipient.

The Study
TParticipants were restricted to caregivers and recipients of care who were 55 years of age or older and who were both members of an HMO. Caregivers were required to take a Caregiver Strain Index (CSI) test to determine their strain/stress level due to their role as a caregiver. Participants were randomized to receive either HEP for usual care (UC) support, and their health care costs were monitored over a period up to 2 years.

Participants who received HEP support participated in weekly and monthly support group meetings that were led by a social worker. Group members were encouraged to interact and turn to one another for additional advice and support. The participants were taught 4 primary strategies:

• Emotional-focused coping strategies
• Education about caregiving and community resources
• Problem-focused coping strategies
• Support

Other topics covered during these sessions included relaxation techniques, networking advice, personal expression of feelings, and nutrition advice.

Participants who received UC support did not receive any additional intervention but were permitted to pursue outside help if desired.

HMO costs and billing for all participants was monitored and kept in accordance with the 1998 Medicare Fee Schedule. These costs were then categorized for the purposes of the study. Costs that were not covered by the HMO or Medicare were not measured.

The Results
The study rrevealed that participants who received HEP had declining costs as compared the increasing costs of those received UC. The primary cause of this difference was a decrease in outpatient costs for HEP participants. Researchers attribute this cost saving to increased understanding of caregiving and improvement of emotional factors for those who were involved in HEP.

The study also revealed that providing for HEP will save HMOs a substantial amount of money in a short amount of time. In this study, HEP provided a total savings of $113,808.00 for HMOs in caregiver costs alone. Combined with the cost savings for caregivers’ spouses, HEP saved the HMO $309,461.14. While this study was not comprehensive and did not include institutional costs or drug costs not covered by the HMO, it clearly indicates the positive financial impact of providing HEP for caregivers and their loved ones.