S1722 National Cost Savings From Avoidable Care for Patients With Inflammatory Bowel Disease via Multidisciplinary Outpatient Chronic Disease Management Teams

Introduction: Patients with inflammatory bowel disease (IBD) often experience flares leading to emergency department (ED) visits. Acute unscheduled care and resulting hospitalizations for IBD have been associated with a lack of standard treatment pathways in the outpatient setting. Multidisciplinary care teams aim to fill gaps in current treatment regimens by reducing flare frequencies and providing a more structured, interdisciplinary, and tailored approach to outpatient IBD care. Methods: We created and ran 1,000 trials of a Monte Carlo simulation to model the impact of the widespread implementation of multidisciplinary care teams for IBD care, using a setting of all EDs in the United States and including all adult patients with IBD as participants. Our intervention uses multidisciplinary outpatient teams for IBD care to reduce hospital admissions, high-cost imaging, and other associated costs. Our primary outcome was to estimate the impact of multidisciplinary care teams for IBD on annual national cost savings and healthcare spending. Our secondary outcomes were estimated national avoidable hospitalizations, bed hours, and CT scans. Results: A multidisciplinary care team approach for IBD set on a large scale would result in annual national cost savings of $47 million (SD ±$4.4 million) and an annual national spending reduction of $1 billion (±$53 million), through a decrease of 6,000 (±661) avoidable hospitalizations and associated 4,000 (±443) CT scans, thus creating 600,000 (±5,000) net new hospital bed hours. Conclusion: Assuming scalability and program costs below our estimated cost savings, implementing multidisciplinary care teams on a large scale would benefit patients and the healthcare system by reducing hospitalizations and associated costs while creating new system capacity for other patients.