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Why professional care managers can help lower costs

Seniorlink said patients tied to tech-enabled care managers used significantly fewer inpatient hospital and ER services.

Jeff Lagasse, Associate Editor

A new study from care collaboration solutions company Seniorlink has found patients experiencing complex conditions had significantly lower rates of inpatient hospitalizations, emergency room visits and falls, resulting in healthcare cost savings, when technology-enabled professional care managers are able to support engaged family caregivers.

The company, in collaboration with Anne Tumlinson, a health and aging services expert and founder of the research and advisory services firm Anne Tumlinson Innovations, analyzed the data of almost 2,000 Seniorlink patients in Massachusetts and Indiana and compared it to the national benchmark Medicare Current Beneficiaries Survey. The study revealed that Seniorlink patients had reduced healthcare utilization and needs when supported by technology-enabled care managers and family caregivers.

[Also: Why telehealth is fueling the move towards micro-hospitals]

In fact, Seniorlink patients used significantly fewer inpatient hospital and ER services than a similarly complex population of Medicare beneficiaries, which if applied to the benchmark population, would result in annual cost savings of $2.8 million for every 1,000 complex patients.

"We're trying to drive better outcomes that essentially lead to better clinical outcomes and lower cost, with a combination of technology and the human touch," said Seniorlink Clinical Transformation Officer Jay Patel.

[Also: Telehealth may increase overall health spending and utilization despite lower cost per episode, says Health Affairs]

A care manager, he said, "could be a nurse or a social worker -- anyone who's in charge of someone's care. We're connecting those individuals with the people who comprise the care team with other resources, like a (family) caregiver, with the goal of optimizing collaboration."

Seniorlink's patients benefited from collaboration, according to the study. They experienced fewer adverse events, and achieved better outcomes, than comparable Medicare beneficiaries who did not have access to the intensive in-home care management model.

When compared with the MCBS data, results showed 32 percent fewer hospitalizations (from about 600 per thousand to 400 per thousand), resulting in a savings of nearly $2,500 per Medicare beneficiary; and 23 percent fewer ER visits (from about 750 per thousand to 580 per thousand), with savings of about $224 per Medicare beneficiary.

While Seniorlink's solution targets Medicaid recipients, the study examined comparable Medicare beneficiaries because more data was readily available. The study focused mainly on Massachusetts, but Seniorlink also operates in six other states.

"The connection point is not only going into the home but providing the technology … and connecting them to us on a daily basis," said Patel. "So we're aware of any symptoms that may arise, and we're getting out in front of those. We're able to facilitate their interaction. A lot of what we do is coaching and supporting the caregiver."

The solution relies on a model of asynchronous communication, meaning the patient doesn't have to rely on someone being on the phone or at the front door. Seniorlink is informed if, for instance, the patient experiences dizziness due to their new medication, or whether they're forgetting things more frequently.

"That allows us to probe, and allows us to do some triage," said Patel. "We're connecting people to the right resources."

Recently, Seniorlink announced the creation of Vela, a new care collaboration technology that integrates family caregivers and care providers in the management of complex patients. The HIPAA-secure platform connects care providers, including nurse case managers, patient advocates and pharmacists, directly with patients and family caregivers.

"A mix of technology and the human touch," said Patel. "That's what has led to the outcomes here."

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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