Being an innovative health care insurer means more than helping members get well only when they get sick and are hospitalized — it means promoting overall wellness and developing new ways to reduce readmissions when those conditions do occur.
As part of our mission to improve the quality of care and the health of our community, Independence Blue Cross (Independence) recently launched an enhanced heart failure care coordination and management program that includes electronic remote monitoring of patients’ vital signs to better coordinate the care of patients with heart failure. Our hope is the program will raise awareness of the condition among our members and help participants identify changes in their condition before they become severe enough to require hospitalization.
Preventing avoidable hospital readmissions
Heart failure is the leading cause of hospitalization in the United States, and one of the most costly conditions to treat. Not only do 1 in 100 individuals aged 65 or older experience heart failure (about 5.8 million nationally), but due to lack of coordinated care, inadequate patient education, and other factors, 20 percent of these patients find themselves back in the hospital due to complications within 30 days of being discharged. In addition, more than 50 percent of patients will be readmitted to the hospital more than once within a year.
In response to this trend, Independence staff physicians and our Informatics team invited high-risk members with heart failure to participate in the enhanced heart failure care coordination and management program.
Removing traditional barriers to care
To implement this program, Independence is working with network providers and ReAdmission Solutions (RAS), an independent company with a proven track record in patient navigation, care coordination, and remote monitoring technology. The program includes the following key benefits:
- scheduling and coordinating doctor’s appointments and facilitating transportation to these appointments through community resources (If available)
- home health visits by nurses (when available)
- electronic remote monitoring of members’ blood pressure, blood oxygen level, and weight
- regularly scheduled phone calls by trained nurses, case managers, and social workers
Through live calls and remote electronic monitoring, members are engaged by the RAS call center staff and changes in condition are immediately reported to the member’s physician for immediate intervention. In addition, rapid response medical orders, previously signed by the members’ physicians, can be implemented.
The program also aims to remove traditional barriers to care, addressing transportation to doctor appointments, medication affordability, and appropriate nutrition. To help our members RAS works with community resources and organizations, like Meals on Wheels to facilitate care.
The program currently has more than 800 participants, and Independence hopes to increase that number to 1,200 participants by the fall of 2015. By continuing to monitor these at-risk members and by promoting the use of innovative member engagement technologies, Independence is improving the quality and access to care and helping to define a new model of personalized, coordinated health care.
Engaging with patients from the comfort of home
Some participating facilities, such as the Abramson Center for Jewish Life and St Joseph, have independently partnered with RAS to test a two-way, remote member messaging, monitoring, and engagement system called the RAS Cube. The device allows doctors to conduct a virtual physical exam through secure video conference and various USB- and Bluetooth-enabled devices, including an electronic stethoscope, scale, spirometer, and glucose monitor.
The RAS Cube is HIPAA compliant (non-cloud based), can connect to any TV screen in the member’s home or hospital room without the need for a computer or tablet, and can transmit vital signs in real time via Bluetooth. Technology like the RAS Cube may break down more barriers and access to care, enabling members to connect with doctors from the comfort of their homes, and also create virtual specialty clinics from a nursing facility or physician’s office.
Check IBX Insights soon for more details about the program, including case studies and success stories.