25 May Shifting Focus from Payments to People: Telehealth-Enabled, Personalized Care for Seniors
By Dr. Ken Kim – In today’s health care environment, there is a significant need for effective remote monitoring programs as part of care protocol.
The United States loses some $750 billion annually to medical fraud, inefficiencies, and other siphons in the health care system. For instance, about 15-25 percent of people who are discharged from the hospital will be readmitted within 30 days or less – many of these readmissions are preventable.¹
Evidence suggests that telehealth stands to lower health care costs, while improving access and quality of care.² Within the Medicare population, ensuring greater continuity and access to care for the most fragile of patients is critical.
As a provider for seniors and patients – chronically ill and others – in the Medicare Advantage population, Alignment Healthcare saw an opportunity to use technology and telemedicine capabilities to better connect a patient’s post-discharge care with the care they received at the hospital or from their physician. Alignment developed a remote monitoring program for chronically ill and recently discharged patients that provides daily monitoring of patients from their own home, including vital sign checks and care plan updates.
The program targets the sickest 10 percent of Alignment’s membership who have poly-chronic diseases and/or advanced illnesses. Members selected most often are those with chronic or high-burden diseases such as congestive heart failure, diabetes, hypertension, COPD or advanced kidney disease. Members may also be selected for acute-care reasons such as post-orthopedic surgery recovery.
Alignment members enrolled in the remote monitoring program receive a package with a Samsung tablet, blood pressure cuff, pulse oximeter and scale. All items connect to the tablet via Bluetooth. A one-hour training for the patient or their caregiver is provided to ensure the technology is understood and works successfully for the patient to complete their vital sign check-ups.
The remote program allows Alignment providers to conduct a virtual visit with a member by phone or tablet that is HIPAA-compliant and fully encrypted. This way, the patient doesn’t need to travel for visits and check-ups and is still receiving attentive care. Additionally, the provider has enough access to know when the patient is meeting the right health levels for their disease or post-discharge protocol.
Because of the program, Alignment’s seniors are seeing reduced 30-day readmission rates across all markets where the remote monitoring program is offered (California, Florida, and North Carolina). These rates are compared to the national Medicare average readmission rate of about 18 percent:
• In 2016, Alignment members enrolled in remote marketing across all markets saw hospital readmission rates of 7.2%.
•California seniors in the program showed a readmission rate of 3.5%.
• Florida saw 0% readmissions for the remote monitoring program.
• North Carolina had a readmission rate of 7.9%.
As telehealth services and the technology that powers them advances, applying these resources to the sickest patients in the health care system may have the most impact on reducing costs without sacrificing quality of care.
For more information on Alignment Healthcare, visit www.alignmenthealthcare.com.
Hyong J. (Ken) Kim, M.D., is chief medical officer at Alignment Healthcare, and responsible for creating, developing and executing Alignment Healthcare’s proven clinical health model, while driving future-state innovation.
¹ Center for Healthcare Quality & Payment Reform. Reducing Hospital Readmissions. http://www.chqpr.org/readmissions.html
² American Hospital Association, Issue Brief: Telehealth: Helping Hospitals Deliver Cost-Effective Care (2016) http://www.aha.org/content/16/16telehealthissuebrief.pdf