Healthcare insurer Humana and patient management vendor AMC Health have partnered to create a 30-day, post-discharge telehealth program for Medicare Advantage members designed to reduce hospital readmissions and ER visits.
Under the Interactive Voice Response (IVR) program, about 1,000 participating members in 35 states recently discharged from the hospital who are at risk for readmission will receive weekly IVR calls asking them about symptoms, assessing pain management and post-discharge needs, as well as reminding them about follow-up physician appointments.
In addition, members will have the option to request a call from an AMC health clinical support team to help gather information regarding members health status, serving as an additional resource to Humana At Homes current care management program. In particular, AMC Health nurses will identify gaps in care, provide coaching and education when appropriate, and arrange for an appointment with the members physician if further intervention is needed.
We know that members leaving the hospital are vulnerable to complications and, although we already have a number of successful programs to help our Humana members transition from hospital to home, were always looking for effective ways to expand those efforts, said Humana At Home President Eric C. Rackow, M.D., in a written statement.
Late last year, Geisinger Health Plan published its own research showing that a telemonitoring program significantly reduced hospital readmissions and cost of care for its Medicare Advantage members diagnosed with heart failure. The study demonstrated 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, with their odds of 30-day and 90-day readmissions reduced 44 percent and 38 percent respectively. The program, which incorporated Bluetooth scales with an IVR solution, also improved the efficiency of care managers and delivered a more than 3-to-1 return on Geisingers investment.
However, another study published in late 2014 found that IVR did not significantly reduce the number of patients with heart failure or chronic obstructive pulmonary disease who were readmitted to the hospital or who visited emergency departments. The authors of the study, published in the American Journal of Managed Care, surmised thatthe poor results could have been the result of poorly executed interventions, or that the study cohort was sufficiently ill to begin with that even ongoing monitoring could not positively affect their health.
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