The Real Sweet Spot in Reducing Hospitalizations
Recently the press have been catching wind to a trend of insurance companies recognizing that coordinating care outside of the hospital equates to lower hospitalizations.
- For health insurer, Geisner, paying nurses to conduct phone follow-ups with chronically ill patients reduced hospital admissions by 18% and overall medical expenses by 7 percent, according to The New York Times.
- Insurer Health Net of Arizona used a “high-intensity telephone management program” to reduce hospitalizations by 40% and save $1,000 per patient, according to American Journal of Managed Care.
Clearly phone follow-ups (also known as tele-care management) are an important element of keeping the chronically ill healthy and at home. However, for patients who can’t self-direct their care, phone follow-up has limited value – which is of interest when you consider that the top 5 percent of the population, accounts for 49 percent of health care expenditure.
That top 5 percent consists of patients who have multiple chronic conditions that are complex to treat. For these patients and their families, a hospitalization is not only costly, but also takes an emotional toll. The much talked about phenomenon of hospital delirium affecting one in three over 70 is one of a long laundry list of factors.
For these reasons, over the last ten years SeniorBridge has been developing a model of service provision that incorporates a multidisciplinary professional team of health providers who offer care management, caregiving and care monitoring services for those with chronic complex health illnesses. The data are compelling.
In a review of SeniorBridge client records that were on service for a year, health outcomes were considerably better than those reported in the general Medicare population. SeniorBridge clients with chronic illnesses who are 65 years and older have 82% fewer hospitalizations and 92% fewer visits to the emergency room, as compared to Medicare beneficiaries with chronic illnesses Additionally, SeniorBridge clients have 46% fewer re-hospitalizations than reported in the recent study published in the New England Journal of Medicine. These outcomes demonstrate that there is both a quality of life and economic benefit to the high-touch approach to in-home care that is provided by a team of healthcare professionals, coordinating care with the physician and the family support system.
“(Insurance companies) are giving primary care doctors more help — and more money — to take care of the sickest patients and help prevent them from becoming sicker. Otherwise, insurers know they risk being overwhelmed by rising health care costs as an older, sicker population copes with serious chronic conditions. “
We’re honored to be helping address that trend.