Geisinger Study Finds Telemedicine to Cut Readmissions, Costs for Heart Failure Patients
A Geisinger Health Plan (GHP) telemonitoring program significantly reduced hospital readmissions and cost of care for members diagnosed with heart failure, according to a recent study published in the journal, Population Health Management.
The telemonitoring program, which incorporated Bluetooth scales with an Interactive Voice Response (IVR) solution from the New York City-based 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 percent per patient per month between 2008 and 2012, GHP reported.
The study 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 in the program, adjusting for patient characteristics and other potential confounders.
A total of 541 members— all GHP Medicare Advantage plan members, who were at least 65 years old with confirmed heart failure—were included in the final evaluation. They had a high prevalence of comorbid conditions (most commonly hypertension and coronary artery disease) and incurred a significant cost of care (average per-patient-per-month cost of ~$1,600). The implementation of the telemonitoring program delivered an 11 percent cost savings during the study period, which is in addition to cost savings attributable to complex care management alone, the study found.
The members in the sample group experienced significant reductions in their probability of hospital admissions, as well as 30-day and 90-day readmissions in a given month. The study showed that the odds of a patient being admitted to the hospital in any given month were 23 percent lower during the months when they were enrolled in the telemonitoring program; their odds of 30-day and 90-day readmissions were reduced 44 percent and 38 percent respectively.
GHP officials said that one of its key elements to successful case management program is timely and appropriate member follow up. Case managers routinely call each member to assess weight changes and ask specific questions about their symptoms. Because telemonitoring provides near real-time data, case managers are alerted almost immediately when biometric readings or IVR responses fall outside of specific ranges. This enables case managers to better identify pre-acute situations that can be addressed in the least costly and most effective care venues, namely the home or doctor's office, rather than the emergency department or hospital setting, the study concluded.
A previous GHP study, published in the journal Medical Care in January 2012, demonstrated the effectiveness of AMC Health's IVR solution to significantly reduce all-cause hospital readmissions.
“Evidence that points to the significant value of remote patient monitoring in enhancing population health management efforts continues to mount. We are thrilled that a second Geisinger study quantifies this benefit for patients diagnosed with heart failure," Nesim Bildirici, president and CEO of AMC Health, said in a statement.
