RPM and a just-released Tel-Assurance Evaluation
Very recently, I wrote about remote patient monitoring (RPM) systems and how they are gaining traction with healthcare payers, such as insurance companies. Historically, health plans have under-invested in optimizing the management of medical expenses, choosing instead to maximize rates where possible. As a result, they’ve experienced high medical losses and have triggered financial pressure and constraints on revenue growth.
Health plans can and are beginning to consistently and sustainably improve outcomes and reduce medical losses by monitoring the daily status of at-risk members through RPM. We’ve just released the results of an evaluation of a large national Medicare Advantage plan that partnered with Pharos Innovations to improve the hospitalization costs in their population. The results speak directly to why RPM systems like Tel-Assurance can play a key role in our healthcare system going forward.
Nationally, 10% to 14% of Medicare Advantage members have heart failure (HF), and they account for 15% of Medicare Advantage plan hospitalizations. Additionally, 25% of those hospitalized are readmitted within 30 days. This is the cycle that RPM can break.
The evaluation results just released covered Medicare Advantage members for a 17-month period from January 1, 2008 to May 31, 2009. The HF cohort experienced 1,639 admissions per 1,000 during the 12-month baseline period. A matched member cohort studied simultaneously experienced no decrease compared to the baseline rate. However, during the same period, Tel-Assurance enrollees experienced an all cause hospital admission rate of only 351 per 1,000, a 79% decrease compared to the baseline period.
Admission rates were highly statistically improved beginning in the second month and remained so throughout the intervention period. Average costs per member per month for those enrolled in Tel-Assurance during the evaluation period was $652, compared with $4,438 for those not enrolled during the same period.
Tel-Assurance enrollees saved $3,785 per member per month.
Our conclusion? Medicare Advantage, and other health plans, can consistently and sustainably improve HF outcomes and reduce medical losses by monitoring the daily status of members at risk for hospital admissions. By driving member behavior change, care management resources can be focused on those who need intervention, allowing health plans to dramatically impact clinical and financial performance.
Tags: Care management, Health plan, Medicare, Remote Patient Monitoring
