Examples of How Hospitals Are Lowering Costs and Enhancing Value

Hospitals in Action

Across the country, hospitals and health systems are changing how care is delivered to make it more affordable, accessible and centered on patients. Below are just a few examples of the many ways that hospitals and health systems are working to make care more affordable for patients.

Sanford Health Is Driving Better Outcomes and Lowering Costs Through the Use of Health Guides

Sanford Health launched a Health Guides program to support patients with two or more chronic conditions — individuals who represent about 15% of Sanford’s patient population but account for roughly 30% of total health spending each year. Health Guides serve as dedicated patient advocates who help individuals navigate the health system, coordinate care with primary care providers and specialists, and ensure treatment plans are aligned across the care team. They also connect patients to critical community resources that address food insecurity, transportation challenges, housing instability and utility access. As a consistent point of contact, Health Guides work one-on-one with patients to schedule appointments, close care gaps and remove barriers that can interfere with managing chronic conditions. By engaging patients early through proactive care coordination and consistent support, the program helps them better manage their health and reduce avoidable costs.

In just six months, 1,050 patients supported through this interdisciplinary care delivery model saw meaningful improvements. Hypertension control reached 69%, A1C levels improved by 65%, LDL cholesterol improved by 42% and PHQ-9 depression scores improved by 50%. At the same time, emergency department visits declined by 69.3% and inpatient admissions decreased by 67.5%. These results reflect how Sanford Health’s coordinated, proactive care model improves patient outcomes while lowering overall costs by preventing avoidable acute care.

Trinity Health Is Supporting Patients and Preventing Hospitalizations Which Lowers Patients’ Out of Pocket Costs

Clinically integrated care teams at Trinity Health are tracking preventable hospitalizations as a core metric and by avoiding these admissions it reduces exposure to inpatient deductibles and coinsurance — a major affordability driver for Medicare beneficiaries. Trinity Health also assigns care managers, community health workers and pharmacists to assist patients with medication affordability, daily costs of living, proper coverage and other social drivers of health that are outside the healthcare system.

Trinity Health’s ACO Has Improved Care and Lowered Costs for Medicare Patients

Trinity Health has effectively demonstrated its commitment to quality and advanced accountable care models that improve the health of our communities.

ACOs accept accountability for the quality, cost, and experience of care of the assigned beneficiary population. ACOs provide Medicare beneficiaries with high-quality, coordinated care including getting them the proper care when they need it, increasing preventive care, avoiding unnecessary service duplication, and preventing medical errors.

In 2023, Trinity Health coordinated high quality care for nearly 120,000 Medicare beneficiaries saving Medicare $28.8M. See more details.

Providence Is Driving Affordability Through Smarter Operations, Technology and Partnerships

Providence’s family of organizations are driving affordability through innovation and scale; being more efficient while reducing costs and improving value.

• Providence’s family of organizations is working to align supply selection and procurement. This lowers supply costs, improves purchasing leverage and reduces waste. These savings contribute to a more efficient cost structure, helping limit the financial burden patients may experience.
• Providence is using data, analytics and artificial intelligence to improve efficiency, assist with claims adjudication, prevent avoidable costs and reduce administrative burdens, which reduces burnout, allows caregivers to spend more time at the bedside and enables them to operate at the top of their licensure.
• Providence is streamlining administrative services and aligning supply chain and vendor contracts across the health system. Reducing duplication and improving coordination lowers overhead and administrative expense, helping moderate the underlying cost of care.
• Providence is prioritizing affordability by advocating for prompt, transparent payment standards that reduce insurer-driven delays, denials and administrative waste that drive up health care costs and impede patient access. By supporting bipartisan Prompt Pay reforms, Providence is working to stabilize hospital finances, reduce systemwide inefficiencies, and ensure patients receive timely, affordable care without unnecessary administrative barriers.

Employee Wellness Program at University of Rochester Medical Center Is Making a Financial Impact While Improving Heart Health Impacts

A new study shows that the UR Medicine Center for Employee Wellness generated a significant return on investment for employers and helped program participants reduce their risk of cardiovascular disease.

Across all levels of cardiovascular disease risk, cost-savings for individuals participating in Employee Wellness programming were $1,224 per person, or a $4.90 return on investment for every $1 spent. Among employees with a moderate to high cardiovascular disease risk who participated in Employee Wellness, 48% improved their risk compared to the predicted risk, and 33% improved by a full category.

That’s good news for both employees and employers, given that about one-sixth of annual healthcare spending is attributed to the treatment of cardiovascular disease, and nearly half of adults in the U.S. have it, according to the Centers for Disease Control and Prevention.

UR Medicine Employee Wellness currently serves 85 organizations throughout Western New York, ranging from school districts to manufacturers, impacting nearly 70,000 individuals.

NebraskaMed’s Patient-Centered Medical Home Improves Outcomes and Can Lower Costs

Preventing a health problem now is much better (and less costly) than overcoming one later. Preventive care aims to detect and treat common conditions as early as possible – when outcomes are better and treatments may be less expensive. It also includes immunizations to help prevent common illnesses and protect vulnerable populations.

“Getting age-appropriate screenings, based on national guidelines, is the best way to find common conditions early,” explains Stephen Mohring, M.D., Associate Professor and Senior Medical Director of Population Health, Patient-Centered Medical Home, and Ambulatory Quality at Nebraska Medicine. “That way, you can begin treatment when it's less invasive, less costly and will have fewer complications.”

Studies suggest that regular preventive care is associated with:

• Improved health outcomes
• Lower mortality rates
• Reduced emergency department use
• Decreased rates of preventable hospital admissions
• Better coordination of chronic disease care
• Higher patient satisfaction

NebraskaMed’s patient-centered medical home (PCMH) is a team approach to primary care. A primary care provider, social worker, clinical staff member, registered dietitian, behavioral health specialist and pharmacist are all part of PCMH.

The goal is to help patients stay healthy, not just get you well. The clinical staff works to keep patients up to date on health and wellness screenings and details regarding personal health conditions. Nurse care coordinators will manage care, including communicating with specialists and assisting with disease management and education.

Patients are treated by a team - during the primary care clinic appointment, the doctor may introduce a pharmacist, dietitian, behavioral health specialist or a social worker, all of whom are already assigned to a patient’s team.

Arkansas Health Network Drives Millions in Savings

As a clinically integrated network, Arkansas Health Network has achieved growth, innovation, and repeated success with both governmental and commercial contracts for the last five years.

Arkansas Health Network was created by its parent company, CHI St. Vincent/CommonSpirit Health, beginning in 2014 as a physician-led network with the goal of building a transformative healthcare delivery model which would benefit providers and consumers across the state. Building on its foundational pillars of a high-value provider network, multidisciplinary care management team and advanced data and analytics platform, Arkansas Health Network has experienced repeated success in the Medicare Shared Savings Program.

The program has continued to grow, Arkansas Health Network has leveraged the same successful model of care and innovative partnerships to record savings and bring value for Arkansas employers. In 2018, Arkansas Health Network partnered with Arkansas Children’s Care Network, a pediatric clinically integrated network, to manage care for the entire family. With employer clients, the CINs collaborate on care management and quality improvement for health plan members. Arkansas Health Network brings its expertise specifically to the adult members, while Arkansas Children’s Care Network focuses on pediatric members. In one example, this partnership demonstrated its success by lowering year-over-year healthcare costs for a local lumber company, Anthony Timberlands. Together, Arkansas Health Network and Arkansas Children’s Care Network generated 14% savings for Anthony Timberlands in 2019. Since then, more employers have become interested in the network.

“CHI St. Vincent is a health system that is already a low-cost provider, and now we are becoming the high-value provider,” said President and CEO Bob Sarkar. “We don’t just want to be cheap; we also want to provide the most value in care.”

Predictive Analytics Keeps 200 Patients from Being Readmitted for $5 Million Cost Savings at Corewell Health

Corewell Health™ care coordinators are using predictive analytics to reduce hospital readmissions and save health care dollars, according to a recently published study in the peer-reviewed journal NEJM Catalyst.

Readmissions are costly, sometimes doubling the cost of care, which makes it a key performance indicator for hospitals. Results from the Corewell Health study, taking place over 20 months in 2021 and 2022, showed that efforts kept 200 patients from being readmitted and resulted in $5 million in cost savings.

“By working in advance of recovery barriers and focusing on whole-person needs, real rates of readmission can be reduced, even for people at high risk for return to acute care,” said study co-author Alejandro Quiroga Chand, M.D., senior vice president, chief medical officer ambulatory care and population health, Corewell Health West.

Nudj Health And Corewell Health Partner on Ground-Breaking New Cost and Utilization Effort; Data Highlights Significant Cost-Savings of Its Whole-Person Care Model

In 2025, Nudj Health and Corewell Health released groundbreaking findings demonstrating substantial reductions in healthcare utilization and cost savings resulting from their three-year partnership together. This announcement follows Corewell Health’s earlier release of clinical outcome data from more than 3,000 patients who completed Nudj Health’s Whole-Person Program. That report documents significant improvements in behavioral, metabolic, and functional health, including:

• 44% decrease in depression scores
• 39% reduction in anxiety scores
• 6% average weight loss
• 9% reduction in triglycerides and 7% reduction in total cholesterol
• 46% increase in daily exercise time

As well as cost and utilization outcomes based on an analysis of patients who completed the program.

• Key findings within 12-month pre and post Nudj program completion data include:
• 73% reduction in encounter volume for mental health
• 68% reduction in encounter volume for obesity
• 38% reduction in encounter volume for diabetes
• 51% reduction in encounter volume for coronary heart disease
• 38% reduction in encounter volume for hypertension
• Direct cost savings, averaging $3,000 per patient for the health system in one year for those who participated in the program for more than 4 months.

“These results clearly show that whole-person, lifestyle-based care is not only clinically effective—it is financially transformative,” said Melissa Sundermann, DO, Medical Director, Lifesetyle Medicine, Corewell Health. “This model meaningfully reduces avoidable utilization while improving quality of life, making it a powerful engine for high-value care.”

Unitypoint Health Has Achieved Over $100 Million in Cost Savings by Leveraging Data Analytics and Partnering with Health Catalyst to Further Optimize Care

UnityPoint Health has achieved over $100 million in cost savings by leveraging data analytics and partnering with Health Catalyst to optimize care. Key strategies include reducing length of stay ($41M saved), improving care management ($32M saved), cutting unnecessary blood transfusions ($17.4M saved), and utilizing telemedicine, resulting in a 39% reduction in ED visits and 54% in, admissions.

Key Cost-Reduction Strategies:

• Data Analytics & AI: Using Health Catalyst's data analytics platform to drive evidence-based clinical decisions, reducing variability in care.
• Care Management & Coordination: Implementing programs that focus on chronic condition management to lower emergency department (ED) utilization and hospital admissions.
• Telemedicine: Partnering with Access TeleCare for neurology and behavioral health, reducing costs by $1.7 million.
• Financial Navigation: Partnering with TailorMed to help patients manage financial burdens and access medication assistance programs.
• Operational Efficiency: Utilizing, for instance, generic, rather than brand-name, medications to reduce pharmacy costs.

These efforts have been recognized with the 2024 Flywheel Award for, achieving significant financial and operational, milestones.