III. CLINICAL OUTCOMES: PROGRESS TO DATE Mount Sinai Brigitte - PowerPoint PPT Presentation

1 III. CLINICAL OUTCOMES: PROGRESS TO DATE Mount Sinai Brigitte Buquez Natasha Toussaint

2 2 The Mount Sinai “On the Ground” Team Proje ject D Dir irector: Brooke Wyatt Ca Care Co Coordinators: Joy Cambe Brigitte Buquez Samara Washington Ashley Pichardo Natasha Toussaint Social W Work Ca Care Co Coordinator: Rachel Potter Dat ata M a Man anager ager: Celia Murnock Peer N Navi vigators: De Shaunda Page Glyn Singleton

3 Mount S Sinai i – Project S ct Summa mary Grap aph 1 1. Mount S Sinai ai P Proj oject I INSPIRE P Patients E Enrolle olled by C Clinic S Site (N=967) 350 31.7% Table 1. Mount Sinai Project INSPIRE Patient Demographics 300 29.1% olled (N=967) Enrol 250 N % of Patients E 19.2% 200 Male 627 64.8% Gender Female 338 35.0% 150 12.6% Number o Trans M/F 1 0.1% 100 7.3% Trans F/M 1 0.1% 50 Black 362 37.4% 0 Hispanic/Latino 357 36.9% Internal Medicine Liver Medicine Faculty Practice Jack Martin Fund All External Sites White 187 19.3% Associates (CAM_IMA) Practice (CAM_LMP) Associates (FPA) Clinic (CAM_JMFC) Race/ Asian 10 1.0% Ethnicity American Indian 3 0.3% Grap aph 2 2. Mount S Sinai ai Proj oject I INSPIRE P Patients Enrolle olled a at External al Two or More Races 17 1.8% Clinic S Sites (N= 1 122) Other 2 0.2% 40 28.7% Pacific Islander 1 0.1% olled 35 Unknown 28 2.9% Enrol 23.0% 30 of Patients E 25 16.4% Manhattan 489 50.6% 20 Brooklyn 178 18.4% 12.3% 15 9.8% Number o Bronx 174 18.0% 8.2% 10 Borough Queens 102 10.5% 5 1.6% Staten Island 24 2.5% 0 Comprehensive Greenwich Beth Israel Roosevelt Ryan Center St. Lukes Institute for Age Mean 58 - Center for Health Village Clinic Clinic - 97th Hospital- Liver Family Health Practice (CCHP) Street Minimum 25 - 93 Maximum -

4 Moun unt S Sinai – Project Summ mmary ( (con ont.) .) • Over two-thirds of our participants (69.2%) are on Medicaid and 16.1% Table 2. Mount Sinai Project INSPIRE Patients by Insurance are dually eligible. Provider (N=967) N % • Approximately 6.9% have Medicare Medicaid 669 69.2% Fee for Service and an additional 7.3% Medicare Fee for Service 67 6.9% have Medicare Advantage. Dually Eligible 156 16.1% Medicare Advantage 71 7.3% Other 4 0.4%

5 Moun unt S Sinai – Project S Summ mmary ( (con ont.) .) Grap aph 3 3. MS INSPIRE T Treat atment C Cascad ade ( (N=967) 1100 99.7% 98.7% 97.1% 1000 lled 91.3% 900 of Patients Enroll 800 74.2% 700 84.3% 600 72.9% 500 Number o 400 300 200 10.6% 100 3.4% 3.4% 0 Enrolled Complete Complete Received Care Complete HCV Started Completed SVR @ 12 weeks SVR @ 24 weeks Stopped Relapsed Assessment Referral coordination Medical Treatment Treatment Treatment Assessment services Asssessment

6 Reasons for Discharge N % Completed Treatment 433 62.48% Lost to Follow Up 137 19.77% Declined Program 24 3.46% Deceased 22 3.17% Incarcerated 2 0.29% Terminated from Program 3 0.43% Competing Medical Priorities 24 3.46% Cleared Virus 11 1.59% Transferred Care 17 2.45% Ineligible upon further review 9 1.30% Other 11 1.59% Total 693 100.00%

7 Mount Sinai Fast Facts • Ti Time t to o tre reatment - 53.5% of INSPIRE patients begin treatment within 3 months of medical evaluation. However, the median time to treatment is 77 days (11 weeks), indicating that the mean is skewed higher by a relatively smaller number of individuals who have taken significantly longer to start treatment. • Previo iousl sly t treat ated p patie ients s - We have 77 patients who were previously treated but stopped that prior treatment without completing. As of now, 52 of them have successfully completed a full course of treatment and 41 have confirmed SVR 12 or 24. Twenty-two others are still undergoing treatment. • Accompan panim iments/ s/Esc scorts- 68 individuals have had INSPIRE staff accompany them to appointments. 38% of this group were previously treated and either stopped treatment or relapsed, as compared with ~24% of the overall Sinai INSPIRE cohort

8 Mount Sinai Fast Facts cont. High Need ed cascade de 600 58% 500 84% High need cascade N 81% 400 Received Assessment 524 82% Medically assessed and 442 300 eligible for treatment 67% Started Treatment 360 200 Completed Treatment 296 100 Confirmed SVR 205 0 Received Medically Started Completed Confirmed Assessment assessed and Treaetment Treatment SVR eligible for treatment

9 Remaining Caseload Progression • Of those who remain, 65.5% are men and 35.6% identify as black, 40.7% as Hispanic or Latino. • Just over half (50.2%) of all participants live in Manhattan, while 19.6% live in Brooklyn and 17.8% in the Bronx. • Participants range in age from 25 to 93 years, with a mean age of 56. • Over two-thirds of our participants (72.7%) are on Medicaid and 14.2% are dually eligible. • Approximately 6.5% have Medicare Fee for Service and an additional 6.2% have Medicare Advantage.

10 10 Remaining Caseload Progression cont. Remain ainin ing MS INSPIRE Trea eatmen ment C Cascade de (N=275) 300 99.3% 98.2% 96.7% lled of Patients Enroll 85.1% 200 67.8% Number o 60.7% 100 15.3% 5.4% 2.7% 0.9% 0 Enrolled Complete Complete Received Care Complete HCV Started Completed SVR @ 12 weeks SVR @ 24 weeks Stopped Relapsed Assessment Referral coordination Medical Treatment Treatment Treatment Assessment services Asssessment

11 11 Reflections “I real ally appr appreciate y you an and d al all y you do do for me me. T Than ank y you forever, I I wish wish t there w was as more I mo I could sa d say o or do do” If it weren’t for INSPIRE coordinators, as one patient explains, she would not have started treatment. The patient was prepared to walk away, but instead took heed to the information her coordinator shared and trusted that this was not the end of the road. After a series of appeals and letters from the care team (coordinated by INSPIRE) the patient started treatment this past April- 6 months post enrollment. The patient also notes that if it weren’t for her coordinator during the first month, she would have stopped taking the medication due to the nausea and insomnia. This is pat patient st story, al although sma small in in st stature, e echoes t the l lar arger me message o our patients s share re p post t treatment; t ; that t they f y feel m more re c confident i in themselv lves, , energ rgized w with a h a better l r life a ahead. .