Written by Ernie Ianace, Chief Sales Officer at VitalTech
Virtual Care is starting to go mainstream.
We are at the tipping point.
Before we start, some sobering facts:
- The U.S. population Above 55 Accounts for 56% of U.S. Healthcare Spend; 75% is Spent on Chronic Disease
- Over 11 million adults have five or more comorbidities, and nearly 35% of deaths are attributed to chronic diseases
- By 2023, nearly 50% of the U.S. population is expected to have a chronic disease, and 75% of healthcare spending is toward chronic disease treatment
- TU.S. U.S. per patient spent on patients 65 years or older is $11,274
- Medicare population to grow from 55M to 75M by 2030
- 3U.S. U.S. patients will use RPM tools by 2024
Targeting the optimal patient population will enhance their lives by better managing their chronic conditions and show a substantial return on investment.
When looking at ROI within a health system or managed care organization, the words “too good to be true” come up often. An ROI analysis is done using known numbers like nationwide averages, dollars spent, rehospitalization cost to the system, numbers of rehospitalizations currently, and known percentages of reduction. When these are looked at initially, the common thought is, “how does putting a monitor on a stage 4 COPD patient keep them from returning to the hospital” The simple answer is that it doesn’t.
Remote and virtual Care affects rehospitalization only when the right patient population is targeted. Monitoring a stage 3 CHF patient will reduce hospitalizations by making appropriate adjustments in Care earlier than if you had no warning. Intervening with Stage 2 patients results in even better outcomes, including longevity and quality of life. At this stage, you can include education and disease state management as part of the remote Care.
The ROI is also influenced by keeping all patient management in-house or outsourcing some basic tasks to third-party care navigation companies. They often operate at lower fixed costs than big health systems. Below is a simple and somewhat conservative ROI analysis for COPD to use as a baseline. Most large health systems implementing the right technology and clinical workflows see better results. An example and one data point from a published study: reduction of hospital readmissions by 76%, and patient satisfaction scores were over 90% (UPMC Case Study)
COPD rehospitalizations at 100 per year
COPD Potential Cost = 100 X $15,200 = $1,520,000
100 Patient Rehospitalization Sample reduced as seen with our customers
100 – 50% = 50
50 X $15,200.00 = $760,000
$760,000 in cost avoidance (50 less at $15,200 each)
Virtual Care Costs
$65-$75 per patient per (Includes Virtual Care platform, tablet with LTE, and equipment for measuring and reporting vitals)
$70 X 100 patients X 12 months = total annual cost of $84,000
One R.N. at $100,000 to monitor and care for patients
Total cost per 100 patients $184,000. This will go down with a larger patient population.
Savings of $760,000 minus the cost of $184,000 for a net ROI of 4.1X
The other major chronic conditions, Diabetes, CKD, CHF, etc… have similar results. Patients with more comorbidities tend to show even better results.
Implementing an aggressive virtual care program seems to be a no-brainer, but there are many things to consider and get right before you see the expected benefits. You must select the right technology partner, one that is flexible and somewhat future-proof. The platform must adapt to different clinical workflows based on disease state and clinical group. It needs to compliment the clinical workflow, not dictate it. You need well-thought-out care pathways that allow for automation and proper care escalation but ensure you continuously refine based on outcome data. And most importantly, you need to define and measure success. In the end, you need a vendor/partner working with you to adapt the system to enhance your clinical objectives and delivery of Care. Virtual Care programs offer a significant and powerful way to meet these objectives for providers looking at ways to improve patient quality, address systems staffing shortages, and minimize the cost of treating their chronically ill patients.
