2015 conference power point

1. REMOTE PATIENT MONITORING
ROI: The Business Case
Georgia Partnership for Telehealth
6th Annual Spring Conference
March 2015
Joseph Ebberwein
Longitudinal Health

2. REMOTE PATIENT MONITORING
THE PROGRESSION:
• Remote Patient Monitoring
• Telehealth
• Chronic Care Management
• Virtual Care
• Population Health Management

3. VOLUME TO VALUE
HEALTHCARE TRANSFORMATION
NEW CARE DELIVERY MODELS:
• Accountable Care Organizations (ACOs)
• Medical Homes (PCMHs)
• Medicare/Medicaid Dual Eligible State Demonstration Projects
• Bundled Payments:
— Medicare Bundled Payment Care Initiatives (BPIC)
— Insurer (Payer) Initiatives
• Self-Insured Employers
• Other Emerging Models:
— Shared Risk
— Shared Savings
— Capitated/Episodic Payment

4. IN HOME TECHNOLOGIES
• BODY
o Vital Sign Monitors
o Activity Monitors
o Sleep Monitors
o Mobile PERS with GPS
o Medication Adherence
Monitors
o Medication Dispensers
o Urine Analyzer
• HOME
o Fall Detection
o Video Monitoring
o Environment Sensors
o Passive Monitoring Sensors
• COMMUNITY
o Social Network
o Social Communication
o Physical & Cognitive Gaming
o Social Networking
o Gaming Technologies
• CAREGIVING
o Caregiving Portals
o Caregiving Coordination
Platforms
Source: Center for Technology and Aging, The New Era of Connected Aging: A Framework for
Understanding Technologies that Support Older Adults in Aging in Place, 2014.

5. VIRTUAL CARE
VIRTUAL CARE ELEMENTS:
• Remote Biometric Monitoring
• IVR:
— Patient Reporting/Bluetooth
• Telephony:
— Health Coach Prescribed Calls
— SN Intervention Calls
• Bi-directional Video Visits (MD,
RN & Patient)
• ADL Monitoring
• Medication Adherence/Reminders
• 24/7 RN Triage
VIRTUAL CARE TEAM:
• Nurse Care Coordinators
• Triage Nurses
• Specialty Nurses
— Cardiology
— Endocrinology/Nephrology
— Neurology
— Oncology
— Pulmonology
— Geriatric
— Wound/Ostomy
• Pharmacists
• Health Coaches
• Behavioral Specialists
• Dieticians

6. THE RETURN ON INVESTMENT

7. RETURN ON INVESTMENT
REMOTE MONITORING EQUIPMENT ADVANCEMENT IN 10 YEARS
Cabled Equipment costing $7,000 to Wireless Peripherals costing $300
Monitoring Costs from $300/month to Tiered Costs ranging from $40-
$130/month

8. RETURN ON INVESTMENT
TELEHEALTH PRODUCES ROI:
 HOSPITALS:
Current: Reduction in Readmission Penalties
Future: Bundled Reimbursement
 HOME HEALTH AGENCIES:
Current: Increase in Staff Capacity (Caseload)
Reduction in SN Visits/Episode
Future: Bundled Reimbursement
Penalties for Readmissions
 SKILLED NURSING FACILITY:
Current: Reduction in Wound Care Costs
Future: Bundled Reimbursement
Readmission Penalties

9. RETURN ON INVESTMENT
• TELEHEALTH:
– Increases Provider’s Care Team Capacity
– Increases Quality Outcomes
– Reduces Expenses of High Risk/High Cost Patients
– Decreases Days in Skilled Nursing Facilities
– Virtual Wound Care
– Reduction in PMPM Cost (SNF, HHA, Hospice)
– Reduction in Provider Liability for Wound Mgt.
– Higher Reimbursement Rates from Commercial Payers
– Decreases PMPM Spend by Reducing Acute Care Hospital
Admissions & Readmissions Rates
– Increases Commercial Payer Contract Reimbursement

10. RESULTS
NATIONALLY PUBLISHED RESULTS:
• VETERAN’S ADMINISTRATION:
— Remote chronic care management
— 17,000 high risk, high cost complex polychronic veterans
— Results:
 63% reduction in hospital admissions
 88% reduction in nursing home bed days of care
— Current Program includes 65,000 veterans
• CMS:
— Care Management for Beneficiaries Demonstration Project
— Remote chronic care management utilizing Telehealth
— 1,757 high cost, polychronic beneficiaries
— 13.3% reduction in costs per patient per quarter
— $542 reduction per patient per quarter
Source: Center for Technology and Aging, Dual Eligible Brief, 2012

11. RESULTS
Source: Advanced Telehealth Solutions
CHF STUDY:
• 83 heart patients
• 4-5 chronic diseases
• 6 month study

12. RESULTS
Source: Advanced Telehealth Solutions
Reduced Hospitalizations for Multiple Co-morbidities
Telehealth Intervention:
• Post Hospital Discharge Program
• Polychronic Disease Patients
• 30 Day Program
• Telephonic Intervention

13. STATE MEDICAID
TELEHEALTH RESULTS
OVERALL RESULTS *:
• Hospitalization Rate:
— 65% Reduction in Hospitalizations
• ER Visit Rate:
— 68% Reduction in ER Visits
RESULTS BY CHRONIC DISEASE *:
• CHF- 59% Reduction in Hospitalizations
• COPD- 63% Reduction in Hospitalizations
• Diabetes- 63% Reduction in Hospitalizations
• Hypertension- 69% Reduction in Hospitalizations
Source: Advanced Telehealth Solutions* Per 1000 Days

14. OPPORTUNITIES

15. PROVIDER OPPORTUNITIES
• HOSPITALS:
– Reduce Preventable 30 Day Readmissions for CMS Designated
Diagnoses with Associated Penalties (CHF, AMI, Pneumonia,
COPD, Hip & Knee Replacements)
• PHYSICIANS:
– Reimbursement for Medicare Care Management Fees
 Chronic Care Management Fee (2015)
 Medicare Transitional Care Management Fee
 Medicare ESRD Care Management Fee
– Managed Care Contracts (Medicare Advantage, Medicaid,
Commercial Payers)
 Chronic Care Management Fees
 Incentive Based Contracts
• POST ACUTE:
– Increases Staff Capacity, Lowers Cost Of Care
– Increases Quality Outcomes
– Reduces 30 Day Hospital Readmissions & ER Visits
– Care Transitions to Home

16. Joseph F. Ebberwein
Longitudinal Health
Joseph.Ebberwein@LongitudinalHealth.com
(888) 670-6787
www.LongitudinalHealth.com