September 14, 2011 – Treatment of patients with chronic disease accounts for nearly four-fifths of United States healthcare spending. But new evidence demonstrating implementation of carefully designed care management and telehealth programs for these patients can significantly reduce healthcare spending. The article, titled “Integrated Telehealth and Care Management Program for Medicare Beneficiaries with Chronic Disease Linked to Savings,” was published in the healthcare policy journal Health Affairs.
A research team explored the economic impact of content-based remote patient monitoring, including Robert Bosch Healthcare’s Health Buddy Program, together with patient-centered care management for high cost Medicare beneficiaries with chronic disease; such diseases include congestive heart failure, chronic obstructive pulmonary disease and/or diabetes mellitus.
The study was implemented within the Centers for Medicare and Medicaid Services (CMS) demonstration project, Care Management for High Cost Beneficiaries (CMHCB) – Health Buddy Program.
Researchers evaluated changes in healthcare spending resulting from patient-centered care management supported by remote patient monitoring. The Health Buddy Program was associated with spending reductions of approximately 7.7 percent to 13.3 percent ($312–$542) per intervention patient per quarter over the two-year period studied.
These data further demonstrate the value of remote patient monitoring; they could suggest savings of thousands of Medicare dollars per patient annually as a result of providing a well-designed care management program with remote patient monitoring in the home.
Researchers observed significant mortality differences between treatment and control groups, which suggests the intervention may have produced noticeable changes in health outcomes. Mortality was not the focus of the study and further research is needed to explore these effects fully, the authors say.
This new evidence of reduced costs and mortality among patients with chronic disease provides solutions to some of America’s most challenging healthcare system problems. They are also in concert with U.S. Department of Health and Human Services (HHS) goals of better care, better health, and lower costs for all Americans.
Analysis of the Health Buddy Program was led by Laurence C. Baker, Ph.D., chief of health services research and professor of health research and policy at Stanford University. Baker managed a team of health economists from Analysis Group.
“Coordinated efforts to treat chronically ill patients are hindered by a fragmented delivery system and discontinuities of care, among a host of other factors,” he says. “With this research, we wanted to examine whether the introduction of this program led to changes in spending for targeted, chronically ill Medicare patients in the traditional fee-for-service portion of the program who were invited to participate.”
The Medicare CMHCB demonstration was conducted at Wenatchee Valley Medical Center in Wenatchee, Wash. and Bend Memorial Clinic in Bend, Ore. The care management teams at both clinics used content-based remote patient monitoring to improve communication with patients, monitor vital sign data and increase the patient’s knowledge about their chronic illness(es). Patient outcomes demonstrated improved care through reduced hospitalizations and improved medication compliance, among other positive outcomes.
Sean Rogers, M.D., medical director of the program for Bend Memorial Clinic said, “The ability for chronically ill patients to communicate their healthcare status to their physician via the Health Buddy System provides an unprecedented ability to truly monitor and manage their care. The convenience of the system empowers patients to take an active role in their care, allowing for more frequent measuring and monitoring of their medical conditions.”
CMS awarded Bosch and the two clinical sites an additional three-year extension as a result of the program’s success.
Research Triangle Institute (RTI) Inc. recently conducted an independent report, Evaluation of Medicare Care Management for High-Cost Beneficiaries (CMHCB) Demonstration: The Health Buddy Consortium (HBC). The report stated ”The HBC program was successful in reducing the rate of all-cause hospitalizations within its refresh intervention group…We also observed an incremental increase in survival benefit among the original and refresh populations’ intervention beneficiaries who used the Health Buddy device relative to the comparison group.” The Health Affairs article published by Baker reinforces this analysis.
Peter Rutherford, M.D., CEO of Wenatchee Valley Medical Center and medical director of the program said, “Home telehealth monitoring in conjunction with case management, treatment protocols, and facilitated communication between the case manager and the patient’s physician clearly improved a patient’s ability to manage their chronic disease. This resulted in an improved quality of life, reduced emergency room visits, hospitalizations, and mortality.”
For more information: www.boschusa.com