Growing Medicare rolls show need for new tech to engage patients

Beneficiaries have widely varied health needs, and population health tools are expected to grow in importance.

As Medicare rolls grow daily, solutions, policies and technologies that address the gap between patient needs and population health will be critical.

This article is part of the January 2023 COVERstory.

Continuing trends of healthcare worker shortages and a growing Medicare population with multiple high-touch care needs have created a perfect storm looking ahead to the next 10 years in the Medicare landscape. 

Solutions, policies and technologies that address a growing gap between patient needs and population health capabilities will be critical in the next few years as patient preferences continue to evolve. Federal policies and initiatives being powered by the Office of the National Coordinator for Health Information Technology are seeking to address these gaps. 

The Medicare population is becoming starkly segmented as patients age with different preferences, abilities and relationships with health technology. Digital population health tools will continue to be critical to managing chronic care at scale in an already overwhelmed system and these innovations require connectivity, access and reimbursement. 

Need for personalization 

Health leaders will be faced with a demand for greater personalization with fewer resources. 

Digital health and telehealth innovators shone during the COVID-19 pandemic to help disrupt a  “provider-centric” model of care delivery and demolish barriers to care, while new policy moves helped to relax requirements around telehealth and expand access allowed for a physical disruption in a provider-centric model.  Most providers and staff have been trained around a model that involves patients coming into the office - waiting for providers in the waiting room then only getting 15 minutes of provider time (which is typically spent reviewing a single data point, like an office-based blood pressure reading) which drives a clinical decision. 

The need for digital health technology and continued models and methods for federal reimbursement is ever greater to drive equitable, patient-centered care that improves outcomes at scale while reducing costs across the board. 

The Medicare patient population in particular is a patient segment where digital intervention and “thinking outside the box” to maximize reimbursements and access to care can have a very meaningful impact to real metrics like ED utilization and hospitalization rates. 

Americans are aging into Medicare coverage at a rate of more than 11,000 patients per day, with the total number of covered lives growing to almost 20 million by year 2030, according to research by Deloitte. Nearly two thirds (66 percent) of patients aging into Medicare have multiple chronic conditions  with high rates of hypertension and diabetes. Policy and providers must unite to allow digital interventions that can manage multi-chronic populations at scale. The typical hypertension management model of taking an office-based blood pressure reading, making a clinical decision and waiting three or six months to see the patient in the office again is not realistic for a growing patient population with evolving needs and preferences. 

While the phrase “meeting patients where they are” has morphed into a sort of north star to enable patient engagement and participation in self-management of care, it highlights a need for technology-enabled services that combine a human touch with scalable, integrated technology. As rates of diabetes among Medicare patients rise, finding ways to effectively and efficiently coordinate care, provide preventative care, adequate patient education and promotion of patient self-management is critical. 

Preventive care’s role 

An assessment of preventive care measures taken for patients with diabetes showed that patients with fewer than eight appointments per year in which the patient’s primary concern is “low priority,” defined as conditions or complaints for which management is not likely to reduce morbidity or mortality, are less likely to receive preventive care services. 

Virtual care management solutions, combined with chronic care management and remote patient monitoring technology, can tip the scale — with care coordination, low-acuity concerns can be addressed outside of the office, leaving more time for providers to address preventative care in the office. 

Tech-enabled services help connect the dots, creating a care community around the patient as an extension of the provider’s office while ensuring relevant and timely patient data is provided to electronic medical records systems via remote patient monitoring. 

Population health leaders, regulators and administrators should be highly motivated to find ways to implement chronic care management and remote monitoring technologies that improve patient self-management, enable efficient provider reimbursement and reduce the overall cost of care. 

Chronic Care Management & Remote Monitoring Technology Reduces Healthcare Utilization, Improves Outcomes and reduces Cost of Care at Scale 

Smarter spending: Costs relating to patients with uncoordinated care are 75 percent higher than those with joined-up medical service provision (Elsevier Clinical Nursing

Reducing the cost of care delivery: Among fee-for-service Medicare beneficiaries, people suffering from multiple chronic conditions account for 93 percent of total Medicare spend  (CDC

Reducing healthcare utilization: Versus fee-for-service patients, CCM beneficiaries require fewer hospital visits by an average of 23 per 1,000 for cardiovascular conditions, and 47 per 1,000 for diabetes issues (Mathematica Policy Research 

Without investments, incentives and creative solutions driven by governmental and private entities to address the growing gap between the needs of the population and the capabilities of the healthcare system, the U.S. is positioned for further disparity in health equity, outcomes and strained emergency departments. 

Federally qualified health centers, rural health centers and others provider organizations that are accustomed to serving large Medicare patient populations have led the way in innovation. But they will need to continue to adopt new solutions as Medicare patients needs become greater and digital engagement preferences become more segmented. 

Sarah Cameron is vice president of care management at TimeDoc Health. 

More for you

Loading data for hdm_tax_topic #patient-experience...