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Impact

PHILADELPHIA— Penn Medicine’s IMPaCT (Individualized Management for Patient-Centered Targets) program has received a 3-year, $1.4 million award from the Patient-Centered Outcomes Research Institute (PCORI) to help three new sites establish community health worker programs, based on the IMPaCT model, to serve 4,600 low-income and chronically-ill Americans.

IMPaCT hires and trains trusted neighborhood residents to become community health workers (CHW) who carry out culturally appropriate outreach activities, social support, patient advocacy, and health system navigation, with a goal of improving health in underserved populations. The roles and activities of the workers are adapted to meet the needs of the communities and residents they serve. IMPaCT is one of the few evidence-based CHW models in the country, having published three randomized control studies consistently showing improved cost, experience and health outcomes. PCORI is an independent, nonprofit organization authorized by Congress to fund research that will supply patients, their caregivers, and clinicians with evidence-based information to make better-informed health care decisions.

In the new project, IMPaCT personnel from Penn will collaborate with the Wilmington, Del. VA Medical Center, the Pittsburgh VA Medical Center, and Blue Cross and Blue Shield of North Carolina’s new Medicaid program to help each of these organizations launch its own IMPaCT program.

“We have proven that this model is effective and has served nearly 10,000 patients in our region. The next stage is national scale,” said Shreya Kangovi, MD, MSHP, founding executive director of the Penn Center for Community Health Workers and developer of the IMPaCT program. “This award will help us determine best practices to continue expanding the program.”

The patient populations for the new project were chosen based on need. For example, veterans have high rates of chronic illnesses (72 percent compared with 40 percent of other adults in the United States) and face up to a 14-fold higher risk of sociobehavioral problems. Medicaid patients generally have poorer health status and outcomes than non-Medicaid patients.

The Penn IMPaCT model includes standardized work practice manuals and specialized software for hiring and training lay residents to become community health workers, as well as operationalizing the program to scale. Duties of the workers are flexible and can include helping patients enroll in programs and benefits for which they are eligible, guiding them toward obtaining health care and social services inside and outside of the hospital system, helping them identify and purchase healthy food, and lending an ear in troubled times.

IMPaCT personnel will team with colleagues in the three new partner organizations and adapt current IMPaCT manuals, training regimens, and software to meet local circumstances while preserving core components, such as hiring procedures, program infrastructure design, and steps for integrating efforts with health care providers. The IMPaCT team will then provide hands-on support with hiring and training the new workers, designing data systems, publicizing and launching the programs, revising as needed, and evaluation.

With input from the partner organizations, IMPaCT has set goals for each the new programs appropriate to the scale of its eligible patient population. The Wilmington program will aim to serve 500 patients per year, the Pittsburgh program will aim to serve 1,000 patients per year, and the Blue Cross NC Medicaid program will aim to serve 3,125 patients per year. Other program goals include reducing all-cause hospitalizations for patients receiving IMPaCT services versus matched control patients, and infrastructure goals such as staff adherence to intervention manuals and stage of program-implementation achieved.

In coordination with Penn Medicine health care teams, IMPaCT has served nearly 10,000 people in the Philadelphia region to date, including hundreds of veterans at the Corporal Michael J. Crescenz VA Medical Center in the city. IMPaCT has been tested in three randomized controlled trials—the same kind used to assess new medications—and has been shown to improve patients’ post-hospital primary-care access, management of chronic disease, and mental health status—while reducing hospital stays by 69 percent.

“IMPaCT was selected for PCORI funding for its scientific merit and commitment to engaging patients and other stakeholders as well as its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Joe Selby, MD, MPH. “We look forward to following the study’s progress and working with Penn Medicine to share the results.”

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $425 million awarded in the 2018 fiscal year.

The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Home Care and Hospice Services, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 40,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2018, Penn Medicine provided more than $525 million to benefit our community.

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