Primary Care Group Working with Stability Health Dramatically Reduces Hospital Admissions

A value-based primary care organization serving a high-risk Medicare Advantage population had done everything right.  Smaller patient panels.  Enhanced access. Coding initiatives.

And yet — their most complex patients with diabetes and cardiometabolic comorbidities were running at 125% MLR, driven by excess hospital utilization. Their frontline clinicians felt stretched and underprepared for the complexity.

So they looked for a different approach.

Within 18 months of partnering with Stability Health, patients enrolled in the program for six months or more had 59% fewer hospital admissions compared to similar patients who never enrolled. For every two patients enrolled for six months, one admission was avoided annually — $14,000 in savings per avoided admission.

The lesson: even well-run, value-oriented practices have a ceiling on what they can achieve within four walls. Closing the gap requires extending care to where patients actually live — between visits, between appointments, between the moments when clinicians can reach them.

Read the full case study to see how we did it.