Managing the financial risks of providing care to seniors presents one of the most intractable challenges managed care organizations (MCOs) face. A senior member’s monthly costs can quickly rise when an unexpected health event occurs, leaving organizations to struggle with a high level of uncertainty.
Today, about 35 percent of older women and 19 percent of older men live alone, according to the Administration on Aging. In addition, more than one-third of people over the age of 65 have impairments that affect hearing, vision, cognition, or mobility.
Can innovative MCOs provide seniors better, more timely access to the right kind of care without destabilizing its financial environment? And is it possible to simultaneously lower the cost of care and increase member satisfaction?
The results of a recent 12-month pilot study, published in the Journal of the American Geriatrics Society, suggest the answer to both questions is “yes.”
Passive remote monitoring technology: high-tech, highly personalized
The study looked at a Massachusetts-based health insurer and care provider, which offered a passive remote monitoring solution by GreatCall (then Healthsense) to dual-eligible senior members. Seniors in an experimental group received wireless sensors for their homes, which monitored activities of daily living such as sleeping, toileting, and kitchen habits.
The in-home wireless sensors collect data and identify baseline patterns of behavior for each individual using proprietary algorithms. For example, sensors in the bedroom can track if a senior gets out of bed more than usual, or conversely, has not left the bed.
When the technology detects a change in an individual’s baseline behavior pattern that could indicate an emerging health issue, it alerts a triage team at GreatCall. Staff then follow up with a call to the senior to assess the situation and determine the appropriate course of action.
By proactively reaching out to seniors and coordinating the right type of care or intervention based on the situation at hand, this high-tech, highly personalized solution can stave off high-cost medical episodes. And unlike other health and safety monitoring solutions, which are dependent upon a senior remembering to use it, passive remote monitoring technology works all the time.
Lower costs for MCOs, higher satisfaction for seniors
Over the course of one year, plan members who used the passive remote monitoring technology lowered their healthcare use.
The study found that total medical expenses for the group with the passive remote monitoring solution amounted to $687 per member per month (PMPM), a nearly 16 percent reduction in PMPM expenses compared to the control group.
A breakdown of the healthcare cost savings shows reductions in several areas, including a 32 percent reduction in acute hospitalization fees, 39 percent reduction in emergency department costs, and 67 percent reduction in long-term care expenses.
Equally as important, seniors who used the remote monitoring solution reported greater satisfaction with their health plan.
“The study demonstrates that passive remote monitoring systems can have a meaningful impact on the lives of seniors, their caregivers, and their families. In fact, 94 percent of the seniors in the study credited the solution with their ability to safely stay in their homes longer,” says Bryan Adams, Chief Commercial Officer at GreatCall. “It is very gratifying when we can help insurers deliver on their mission to improve member experiences while reducing health-related costs.”
One can safely call that a win-win solution.