More than half a billion dollars. That’s the recently released total for readmission penalties the federal government will be withholding in Medicare payments from over half the nation’s hospitals in the coming year. In this type of environment, healthcare systems are scrambling to find new solutions to address post-discharge patient needs—both to proactively improve the quality of care and to decrease the financial ramifications of negative outcomes. The good news is that with continued advances in the sophistication and adoption of technology, connected health solutions that integrates patient-generated health data (PGHD) can help address these needs and lower readmission rates.
Driving the need for change
As a component of the Affordable Care Act (ACA), the Hospital Readmissions Reduction Program went into effect in October 2012. The provision requires the Centers for Medicare & Medicaid Services (CMS) to reduce payments to hospitals that see an excessive number of readmissions from patients with specific conditions within 30 days after discharge. Although the number of hospitals penalized this year is about the same as last year, the penalty amount is a record.
There are many concerns about these penalties, especially for hospitals that care for large populations of low-income and vulnerable patients—who often don’t have access to needed resources to follow recommended post-discharge regimens. Factors such as these and others impact a patient’s recovery and are largely beyond the hospital’s control after a patient is discharged. In addition, many patients who are readmitted suffer from one or more chronic diseases that contribute to the need to return to the hospital. According to the U.S. Centers for Disease Control and Prevention (CDC), chronic diseases are responsible for seven of every 10 deaths per year, and treating them accounts for 86 percent of our nation’s total healthcare costs.
The confluence of such factors makes the use of remote patient monitoring (RPM) and the ability to leverage PGHD increasingly critical in today’s healthcare environment. When healthcare providers are able to access real-time, real-world and actionable data, they can monitor patients more closely and provide early intervention that not only improves the quality of care—but may prevent a readmission in the process.
Proving the value of RPM and PGHD
There are many examples of how healthcare systems are using RPM and making the most of PGHD to lower readmission rates. In fact, according to a recent report from Spyglass Consulting Group, 66 percent of healthcare systems have already deployed RPM technology in order to improve patient outcomes and support population health—especially for those with complex chronic conditions.
One specific example is Brockton Hospital, part of the Signature Health System in Massachusetts. In partnership with iGetBetter, Brockton is leveraging PGHD to reduce readmissions for patients with heart failure and chronic obstructive pulmonary disorder. A pilot involving 31 patients with heart failure conducted in 2014 aimed to reduce readmissions using connected blood pressure monitors and weight scales to feed the PGHD directly into iGetBetter’s care management portal. Historically, Brockton typically experienced a 28 percent readmission rate, meaning that eight of the 31 patients in the pilot would have been readmitted—at a cost of $27,000 per readmission. In this study, zero patients were readmitted, leading to an immediate savings of $216,000.
The Partners HealthCare Center for Connected Health is another example. This not-for-profit integrated health system in Boston utilizes activity trackers, as well as connected blood pressure monitors and scales, to treat and manage chronically-ill patients and those recovering from surgery. One of their programs focuses on patients with congestive heart failure (CHF) to detect daily changes in weight, heart rate, movement, sleep and blood pressure. Clinicians monitor this information and use telehealth services to educate patients about the significance of changes—Intervening when needed in collaboration with the patient’s physician. The result has been a reduction in heart failure-related hospital readmissions by over 50 percent.
Programs like these demonstrate the immediate value of using remote patient monitoring and patient generated health data to improve the quality of patient care and reduce readmission rates as a result. By integrating connected health initiatives into the delivery of care, healthcare systems are better able to focus on meeting the post-discharge needs of patients wherever they may be—and keeping them out of the hospital as a result.
Do you think PGHD can make a difference in readmissions? Join the LinkedIn discussion in the HIMSS group.