© Randy for The Collaborative Forum, 2011. | Permalink | No comment | Add to del.icio.us
Post tags: Care coordination, CMS, Remote Patient Monitoring

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The genesis for this study stretches back nearly 10 years, from conceptualization to the results we see reported today. This randomized, controlled multi-centered trial was designed to compare an automated, daily symptom and self-reported weight monitoring technology with “usual care” in reducing hospital readmissions and mortality among patients recently hospitalized with decompensated heart failure. The boldness of vision should not be underrepresented: Tele-HF is the largest study of a non-pharmacological intervention for heart failure ever conducted.

At a high level, the results showed “no significant differences” between the group receiving usual care and the group randomized to receive telemonitoring. I cannot say that these are the results we were hoping for. However, I urge those in our industry and other key stakeholders to take a closer, more informed view, and to reach their own conclusions and insights.

The Details

First, I want to thank and acknowledge the great work of the investigators, study sites and everyone involved in this trial. It was a long process and everyone worked with the utmost integrity and professionalism. We were privileged to have been selected for participation.  I also want to acknowledge the value of conducting large, multi-centered, randomized, controlled trials in terms of advancing medical science.

The patient interventions in this study took place in 2006-09 and omit many of the processes and techniques Pharos uses today to achieve the necessary critical mass of physician and patient involvement. Here are the limitations of this particular study – from my perspective: (more…)

© Randy for The Collaborative Forum, 2010. | Permalink | No comment | Add to del.icio.us
Post tags: Care management, Disease management, Remote Patient Monitoring

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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. (more…)

© Randy for The Collaborative Forum, 2010. | Permalink | No comment | Add to del.icio.us
Post tags: Care management, Health plan, Medicare, Remote Patient Monitoring

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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. (more…)

© Randy for The Collaborative Forum, 2010. | Permalink | No comment | Add to del.icio.us
Post tags: Care management, CMS, Disease management, Health plan, Medicaid, Medicare, Population Health, Remote Patient Monitoring

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Table of contents for Medicare's Medical Home Challenge

1. The Medicare Medical Home Demonstration: Crawling Out From Under the Rock – Part II

Vince’s post begs the question: “So…if one were to redesign the MMHD to fulfill the potential for both improving care quality (through access to an appropriate “Medical Home”) while simultaneously reducing healthcare costs, where might we start?”

Vince points us in the right direction in his post, calling our attention to the work of Randall Brown in his report of another CMS demonstration, the Care Coordination Demonstration. Brown points out two key observations:

1. Care Coordination, to save money, must start with the “right” population target; and,

2. Care Coordination interventions can only save money if they don’t COST more than about $120 per participant per month (the amount likely to be saved from a well-designed intervention).

In other words, the solution to the dilemma has two aspects: 1. FOCUS and 2. EXECUTION. (more…)

© Bonni for The Collaborative Forum, 2009. | Permalink | 2 comments | Add to del.icio.us
Post tags: Care coordination, Care management, CMS, EMR, Medical Home, Medicare, Remote Patient Monitoring

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