According to a new article released last week in Home Health Care News, older Medicaid patients with high-risk conditions or behavioral health needs represent “a vulnerable population at risk of falling through the cracks, unless they receive the right in-home technology solutions.”
And based on current Medicare Advantage (MA) figures, the challenge is growing in scale: More than 3.8 million Medicare beneficiaries were enrolled in Special Needs Plans (SNP) in 2021. That SNP count has risen steadily this past decade, from 1.25 million in 2010 to the present 15% of total MA enrollment.
New Approaches to RPM Highlight a Solution
Offering an in-depth look at this issue, a new customer testimonial video highlights how HealtheMed – an organization dedicated to improving the lives of the Medicaid participants living isolated at home – uses the EarlySense® InSight® at Home solution to deliver its [email protected] service to a population of Medicaid clients.
The InSight at Home solution is built on EarlySense medical-grade technology, re-engineered for the home. It utilizes a contact-free, under-the-mattress sensor to collect patient digital biomarkers continuously and passively.
The solution’s Vital Signs Cellular Processing Unit, powered by AT&T IoT, analyzes and securely transmits core vital signs, movement and sleep data to the cloud, where it is integrated into HealtheMed’s patient-facing dashboards.
With enormous degrees of success.
Both the article and video explore the myriad ways patients, providers and the payor (CMS) have benefitted from the joint initiative:
- Nearly 100% compliance rates;
- Cost savings through early identification of patient deterioration; and
- The ability to address mental health challenges using an RPM solution.
Boosted Compliance Rates
As conveyed through interviews with multiple staff members, HealtheMed has been able to reach close to 100% monitoring compliance rates during its overnight monitoring time periods with InSight at Home. This represents a significant boost, as traditional monitoring solutions’ compliance rates typically hover around 50%.
“All the patients have to do is sleep,” said Shannon Holly-Smith, BSN, RN and Nurse Director of HealtheMed. “They don’t have to remember to take their blood pressure, they don’t have to get on the weight scale in the morning – all they have to do is get into bed.”
Cost Savings Across the Board
“Using remote patient monitoring with this Medicaid population, we’re able to bring hospital-grade tech into the home,” said Jennifer Bishop, Senior Clinical Manager at EarlySense. “You’re capturing trending data to flag any kind of deterioration and manage medication. It fosters a sense of wellbeing and enables the client or patient to be more proactive, leading to a better relationship between patients and caregivers, while keeping them out of the hospital or ER.”
This advanced monitoring leads to increased data flow and key clinical insights on a wide range of vital signs, including heart rate, respiratory rate and sleep patterns – all collected overnight.
“With our patients who are managing multiple chronic conditions, having a constant stream of vitals data gives us the ability to understand what happened the night before – allowing us to take corrective steps and action before they might need to make a trip to the hospital or emergency room,” said Ron Mandelbaum, Founder and Chief Revenue Officer of HealtheMed. “And this saves both time and money across the board – from patients to providers to CMS.”
Addressing Behavioral and Mental Health
“The HealtheMed patient is typically someone who has a behavioral health issue, maybe high anxiety,” says Terry Duesterhoeft, Chief Product and Commercial Officer at EarlySense. “They’re very nervous about technology and privacy. And they might also have physical or medical handicaps that would preclude them from taking their own vital signs or using a traditional remote-patient monitoring modality, like blood pressure or weight or even blood glucose. In addition, they often have several medications that they’re trying to manage on top of the chronic condition or some other medical condition.”
Most healthcare providers aren’t able to take on in-home management of patients with mental health issues – even though those patients have much better outcomes when they’re cared for at home. This leads to high care costs, as patients have to rely on more expensive nursing staff to be in the home with them for longer periods of time, because RPM solutions often can’t achieve the right compliance levels to be reimbursed.
InSight at Home addresses those issues.
“The Medicaid special-needs population is the most challenging health care delivery environment, as you’re in complex settings with a population that doesn’t have good compliance to begin with,” said Mr. Duesterhoeft. “This idea of a contact-free modality where compliance is automatic really opens up a much larger monitorable population for caregivers than there has been in the past.”