Afib Home Health Compliance

1. Afib Home Health
Compliance Inc.
(Formerly Afib Supplemental Insurance Inc.)
Presented by: Hans Schick
NYU Healthcare Innovation Makerthon
Revised for Pfizer Corporate Presentation
January 25th, 2016

2. Direct Costs* of Afib
The total cost picture of Afib is complex: Direct Costs,
Indirect costs, lost productivity.
In a privately insured population direct costs were $15,553
per year among enrollees with Afib, which were $12,239
higher than the costs per year for enrollees without Afib
Company Goal: Offer savings to our customers of at least 3
X Service cost. ($1,500/patient charge, results in at least
$4,500 in reduced Afib costs to primary insurer)
*http://www.ajpb.com/journals/ajpb/2012/ajpb_marapr2012/Economic-Burden-of-Atrial-Fibrillation-Implications-for-Intervention

3. Problem: Payers cost associated with lack of Afib
Compliance
Solution: Technology + Data Management +
Personal Touch = Increased Compliance and
Reduced Costs
Afib Home Health Compliance Inc Service:
 Rigorous Follow-Up and Personal Attention to each patient
 Focus on Preventing Stroke and Bleeding Events
 Mobile Health Monitoring of daily medication:
https://www.youtube.com/watch?v=REqSsSTtJI4
 Daily Blood Thinner Pill Tracking and dispensing meds
 Complete Data Management of INR history
 Take necessary action when results are out of compliance
 Monthly at home INR measurements by medical technicians
Service Cost: $1,500/patient per year billed to insurance company

4. Service Benefits 3 Parties
1. Patient: Prevent stroke and bleeding
events
2. Insurer (Customer): Reduce costs for
insured Afib patients
3. Pharma: Gather clinical data from monthly
INR tracking

5. Estimated Labor Costs
Testing Patient at Home: 30 minutes
Data Entry and Review: 10 minutes
Travel Time between patients: 30 minutes
Time per Patient/month: 70 minutes
Patients Tested in 8 hour work day: 6.8
Patients Tested per Month (40hours/week): 136
Reveune Potential per Full Time Nurse: 136 X
$1500/year= $204,000
Median Income for Home Nurse: $74,208
Gross Profit per Full Time Nurse: $129,792

6. Developing an MVP Service:
1. Prove that we can drive down Afib Costs by X3 –X5 of the
service cost.
2. Trial involving 2 Medical Technicians tracking and testing 50
Afib patients each for 3 months.
3. Develop the work flow and integration of technology with
home visits
Costs to Develop MVP:
Hardware, Software Purchase: $25,000
Hire 2 Home Health Nurses full time for 3 months: $18,5000 each,
$37,000 total
Total Approximate Funding Needed to Develop MVP Service:
$87,000

7. Appendix

8. The Problem with how we currently reduce
stroke risk associated with treating Atrial
Fibrillation (Afib)
 Current blood thinners (Warfarin) used have a narrow
therapeutic window. Patients must maintain an INR
(Intensity of Anticoagulation) of 2 to 3
 If the patient has too low of a INR level risk of stroke
increases. If patient’s INR level is too high bleeding risk
increases. The narrow therapeutic window makes
compliance problematic
 Industry needs to move from looking at individual INR
points to looking at TTR (Time in Therapeutic Range) over
a period of time.

9. Consequences of Poor INR Control
Poor TTR<60% Moderate TTR = 60 to 75% Good>75%
Mortality 4.2% 1.84% 1.69%
Stroke 2.10% 1.34% 1.07%
Bleeding 3.85% 1.90% 1.58%

10. Large Market Potential in USA
25% of Patients Over 40 yo will
develop Afib in their life time.
75% Afib patients over 65yo
15% of US population over 65
Approximately 300M People in
USA
45 Million person Market+

11. Monitoring Compliance: Simple for elderly
and people dealing with multiple conditions
RED: TTR < 60%
YELLOW: TTR 60% to 75%
GREEN: TTR > 75%