High Tech, High Touch Health Care February 5, 2015 2015 Qualcomm Life. All rights reserved. 1
Tectonic Shift in Care Delivery
Home is the fastest growing care setting in the US. Source: AHRQ, Agency for healthcare research and quality 2015 Qualcomm Life. All rights reserved. 3
Care is Moving Home 13.6M # of patients age 65 years or older discharged 19.6% % of Medicare beneficiaries annually in the US 1 rehospitalized within 30 days of discharge 2 $33.6B Loss in productivity attributed to employees caring for aged dependents 3 1. CDC, National Hospital Discharge Survey, number and rate of hospital discharge, 2010 2. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New Eng J Med 2009;360:1418 28 3. Metlife Mature Market Institute and the National Alliance for Caregiving 2015 Qualcomm Life. All rights reserved. 4
The Tectonic Shift Value-based reimbursement for health systems CMS bundled payment models Managing larger at-risk populations Desire to move patients to lower cost care settings sooner Hospitals will be responsible for readmissions 2015 Qualcomm Life. All rights reserved. 5
The Tectonic Shift New emerging care models Chronic Care Management (CCM) Transitional Care Management (TCM) Continuous, informed care in the home 2015 Qualcomm Life. All rights reserved. 6
Chronic Care Management (CCM) in the Spotlight Effective January 1, 2015 Medicare will begin reimbursing eligible providers for remote chronic care management under CPT Code 99490 Average payment of $40.39 per patient, per month Total Medicare potential CCM reimbursement in 2015 $16B 2015 Qualcomm Life. All rights reserved. 7
Chronic Care Management Requirements Two or more chronic conditions Provider must establish comprehensive care plan Provide at least 20 minutes of non-faceto-face care Provider must have five specific capabilities to perform CCM: Use a certified EHR Maintain an electronic care plan Ensure access to care Facilitate care transitions Remote coordination of care 2015 Qualcomm Life. All rights reserved. 8
Enabling Technologies Powering Chronic Care Management
Seamless Connectivity Platforms (RPM) Interoperability Security Scalability Benefits / Outcomes Interoperability among healthcare ICT systems would deliver a national annual savings of $77.8 billion 1 Remote monitoring reduces readmission by 44% 2 Secure exchange of vital information across health care settings 1 C. Bock, L. Carnahan, S. Fenves, M. Gruninger, V. Kashyap, B. Lide, J. Nell, R. Raman and R. Sriram, Healthcare Strategic Focus Area: Clinical Informatics, National Institute of Standards and Technology, Technology Administration, Department of Commerce, United States of America, pp.1-33, September, 2005. 2 Population Health Management, Volume 0, Number 0, 2014a, DOI: 10.1089/pop.2013.0107 5 2015 Qualcomm Life. All rights reserved. 10
Exception-Based Management Remote monitoring integration and visualization of data Reflex algorithms - near real-time alerts Smart dashboards for efficient care management Benefits / Outcomes Reduce rehospitalizations for HF by as much as 72% 1 Deliver population level interventions Focus resources based on documented needs Manage large at-risk populations effectively 1 Weintraub AJ, Kimmelstiel C, Levine D, et al. A multicenter randomized controlled comparison of telephonic disease management vs automated home monitoring in patients recently hospitalized with heart failure: SPAN-CHF II trial. Program and abstracts from the 9th Annual Scientific Meeting of the Heart Failure Society of America, September 18-21, 200, Boca Raton, Florida. Recent and late breaking clinical trials. 2015 Qualcomm Life. All rights reserved. 11
Asynchronous Communication Secure record sharing Near real-time therapy and medication adjustments Dynamic care plan 1 de Jong CC, Ros WJ, Schrijvers G, The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review, J Med Internet Res 2014;16(1):e19 2 Steventon A, Bardsley M, Billings J, et al. Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial. BMJ 2012;344:e3874 doi: 10.1136/bmj.e3874 (Published 21 June 2012) 2015 Qualcomm Life. All rights reserved. Benefits / Outcomes Decrease in physician visits 1 Increase in self-management/self-efficacy 1 Fewer emergency admissions (20% reduction) 2 Decrease in mortality rates (45% reduction) 2 Improve clinical collaboration 12
Qualcomm Life CCM Solution Wireless remote patient monitoring Symptom tracking programs Dynamic care plan Secure access and sharing Asynchronous communication On-line medication management tools 2015 Qualcomm Life. All rights reserved. 13
Opportunity to Set New Standards
High Tech, High Touch Best Practices Brad Tritle President/CEO,vitaphone