Virtual care strategies align with value-based reimbursement

Providers who integrate remote care management (RCM) strategies into their post-discharge protocols will be well positioned as reimbursement transitions from fee for service to value based, an executive wrote April 4 in the Health Affairs blog. His hospital reduced congestive heart failure 30-day readmissions by 4 percent using RCM technology.

Intermittent contact with patients and access to sporadic data impede a physician’s ability to provide timely care if a patient’s health declines after discharge for chronic conditions such as heart failure, wrote Allen D. Snell, MD, former chief medical information officer at St. Vincent Health in Indiana. Virtual care models overcome those barriers by collecting patient data daily, which nurses can monitor for early warning signs and take proactive steps to prevent avoidable readmissions. The approach also can be used to educate and engage patients.

The health system conducted a demonstration study designed to evaluate the effectiveness of RCM technology in managing patients with chronic conditions. The trial enrolled approximately 200 patients with congestive heart failure or chronic obstructive pulmonary disease between 2011 and 2012 who were monitored with RCM tools for 30 days after discharge.

Compared with the national average, St. Vincent achieved a 70 percent reduction in readmissions. Patients in the intervention group also were more engaged in their care than patients in the control group.

“[We] demonstrated a clear association between RCM and fewer hospitalizations and healthier patients,” Snell wrote. “Yet, in conversations, my team and I have found some healthcare systems reluctant to embrace such findings and this new care model because they are predominantly reimbursed in a fee-for-service model.”

With reimbursement shifting to a value-based system, RCM technologies will play a more prominent role in patient care, he proposed. Providers who want to get ahead of the curve should develop programs using interactive RCM tools such as video conferencing. These tools will allow them to connect with patients, which will lead to more personalized care, improved health and lower costs.

Snell is now director for the Regenstrief Institute of Medical Informatics in Indianapolis.