Dun & Bradstreet Logo

Adam Anderson

Cutting costs of long-term care: telehealth

by Adam Anderson | Dun & Bradstreet Editor

August 1, 2012 | 4 Comments »

BIZMOLOGY — In my post last week about the changes facing the nursing home industry, I talked about the growing numbers of patients who instead of living in nursing homes or other long-term care facilities were receiving in-home care. The importance of home health care is going to only grow.

One way that home health care is going to expand is through telehealth technology. Patients who have a chronic health condition that requires routine monitoring, such as heart disease, can benefit from telehealth. Patients use a simple monitoring device at home that takes their blood pressure, weight, oxygen saturation, and other key indicators, and then that information is transmitted to staff at the home office.

Meridian Health‘s  Meridian at Home is using such devices in its home care operations. As reported in the Asbury Park Press,

From remote medication-management programs to home health-monitoring systems, so-called “telehealth” is becoming increasingly commonplace in today’s high-tech environment. Health care experts confirm that [the patient’s] ability to transmit daily readings of her vital signs through Wifi hookups to attending doctors and nurses for evaluation is just the beginning of a systemwide evolution to more home-based practitioning.

Telehealth devices don’t replace doctors. However, they do replace office visits, which may be difficult for housebound patients to manage. And perhaps most importantly, they reduce hospital readmissions, one of the leading causes of high health care costs. Medicare‘s new readmission policy penalizes hospitals whose readmission rates are too high by reducing their reimbursements. Telehealth is one of the ways that the health care sector hopes to keep sick patients out of the hospital. And it seems to be working.

The $57 billion home health care industry has undergone a lot of changes. Initially conceived as transitional care after hospitalization, home health care now mainly serves elderly patients with chronic conditions. This changing business model is ripe for high-tech solutions, and medical device manufacturers are stepping up to provide them. Additionally, accountable care organizations (ACOs) are reaching out to home health care companies as a way to bring them into the fold. ACOs are specifically called out in the ACA as a way to cut costs and streamline care.

There will be no single solution to the dual goals of the new health care model. Increasing access is all well and good, but just increasing access to care is not making it affordable. Right-sizing care will also be important, and home health care high-tech will play a significant role.

Rebecca Mallett

I can definitely see the benefits of telehealth for homebound patients, for reducing hospital readmissions, and for keeping costs down. It seems like a practical supplement. Doctors may have better monitoring of the patient when they are at home and perhaps that will cut down on some office visits. However, elderly patients, who probably have the hardest time getting to the doctor, are also the patients that probably most need to see the doctor in person. Many have multiple medical conditions and multiple medications, making their healthcare more complex. It will be interesting to see how well telehealth transitions from after hospital care to a regular office visit replacement system.

That’s a good point, that the frailest patients have the most need to see the doctor in person. I think that telehealth in combination with the accountable care organization and the medical home — another term for caring for the patient in concert with all of his or her medical practitioners — will be able to support patient care. It won’t replace doctor visits but will support it by providing more up-to-date information.

Great post, Patrice. I’d like to hear more about why, exactly, telehealth leads to fewer readmissions. Is it because problems are caught earlier or what? Also, I’ve never heard of ACOs before. I’m thinking that might warrant a post on its own.

From what I understand, being able to monitor for changes in symptoms is allowing providers to catch growing problems early. So for instance if blood sugar starts to skyrocket or if heart disease symptoms change, having a history of readings allows doctors to keep up with these changes that might be missed even if someone has a monthly visit to the doctor.

I also think that human psychology is a factor. If a patient becomes more aware of their own health care, then they have more control over their outcome.

Leave a Reply

Your email address will not be published. Required fields are marked *