The Collaborative Forum

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. Read the rest of this entry →

Clearly, the need to reduce healthcare costs without affecting the quality of healthcare delivered is at the center of our country’s healthcare debate.  However, a recent BusinessWeek article of February 4, 2010, by Chad Terhune and Arlene Weintraub, makes the mistake of lumping together all disease management programs and then goes on to cite examples in which particular programs have demonstrated no cost-savings nor any apparent increase in the health of patients. 

That is not, however, true of all programs that aim to manage chronic disease and demonstrate reduced costs.

As a cardiologist and CEO of Pharos Innovations, a company that focuses on managing chronic disease while demonstrating real reductions in avoidable hospital admissions and overall healthcare costs for Medicaid, Medicare, the VA, commercial health plans and provider systems, I think it’s important to set the record straight. There ARE well-proven ways to reduce costs AND keep patients healthier. Read the rest of this entry →