Telemonitoring of heart failure patients reduces readmissions

A Geisinger Health Plan (GHP) telemonitoring program significantly reduced hospital readmissions and cost of care for members diagnosed with heart failure (HF), according to a study published in Population Health Management.

The telemonitoring program, which incorporated Bluetooth scales with an Interactive Voice Response (IVR) solution from Advanced Monitored Caregiving (AMC Health), also improved the efficiency of care managers and delivered a 3.3 return on GHP’s investment-in other words, for every $1 spent to implement this program, GHP saved about $3.30. The savings amounted to approximately $216 or 11% per patient per month (PPPM) between 2008 and 2012.

The study, led by Daniel D. Maeng, PhD, research investigator at GHP, Center for Health Research, compared inpatient admissions and total cost of care incurred by HF patients during the time when they were enrolled in the AMC Health telemonitoring program against those incurred when they were not enrolled.

A total of 541 members were included in the final evaluation. These patients were all GHP Medicare Advantage plan members, at least 65 years old with confirmed HF, and had maintained their plan membership for the 70-month study period. They had a high prevalence of comorbid conditions (most commonly hypertension PPPM cost of about $1,600).

Threading process into existing best practices

“The remote monitoring approach was simple,” says Jonathan Shankman, senior vice president, clinical innovation, AMC Health, a telehealth solutions provider. Bluetooth scales automatically transmitted patients’ daily weight to the cloud, and symptom information was solicited through regular automated IVR telephone calls. Both processes could issue real-time alerts to remote care managers, helping them prioritize which members needed their attention first, he says.

The members in the sample group experienced reductions in their probability of hospital admissions. The study showed that the odds of a patient being admitted to the hospital in any given month were 23% lower during the months when they were enrolled in the program; their odds of 30-day and 90-day readmissions were reduced 44% and 38% respectively. The odds of any member being hospitalized for any reason while on remote monitoring were 23% lower relative to when they received case management alone, says Shankman.

“When remote monitoring processes are threaded into existing complex heart failure best practices, members with congestive heart failure [CHF] can expect to see significantly lower utilization and cost than with case management alone,” he says.

The intention of the study was to see the additive value of remote monitoring, and to quantify that value both in terms of clinical effectiveness and cost, says Shankman. “These flexible remote monitoring technologies can be readily threaded into exiting clinical best practices,” he says. “In doing so, they can dramatically reduce utilization by detecting pre-acute scenarios in a far more timely manner, while simultaneously extending the reach of a care management team otherwise overwhelmed by unscalable manual processes.”

Tracey Walker is content manager for Managed Healthcare Executive.