Keeping older adults out of the hospital and moving care into the home has been effective in cutting costs and improving overall health outcomes. One home health company has been able to lower its hospital readmission rates by utilizing remote patient monitoring software.
The company is Paramus, New Jersey-based Valley Home Care, a home health services provider that cares for more than 12,000 people in Bergen and Passaic counties. Founded in 1987 and a part of the Valley Health System, the provider also offers hospice and palliative care, in addition to several other in-home services and supports.
Over four years ago, Valley Home Care made the switch from a more traditional telehealth program to remote patient monitoring software developed by Health Recovery Solutions for its cardiac patients.
As a result, it saw its monthly hospital readmission rates drop to as low at 2%.
Hoboken, New Jersey-based Health Recovery Solutions provides medical centers and home care agencies with a comprehensive remote monitoring platform, complete with blood pressure monitors, scales and pulse oximeters.
Since launching in 2012, Health Recovery Solutions has worked with a number of home health organizations and health systems to implement its telehealth solution. That list includes NVNA and Hospice, Community VNA, Ohio Living Home Health and Hospice, Well Care Home Health, and Frederick Memorial Hospital.
“We have 140 medical centers that use [Health Recovery Solutions] and a lot of them happen to be home health agencies,” Jarrett Bauer, Health Recovery Solutions CEO, told Home Health Care News. “We tend to work with the most innovative health systems in the country. This usually means large health care systems that have ACOs, population health departments or home care agencies.”
As far as results from other providers outside of Valley Home Care, Ohio Living Home Health and Hospice saw a 7.5% hospital readmission rate after implementing remote patient monitoring and telehealth software from Health Recovery Solutions. Meanwhile, Community VNA reported a 55% reduction in hospital readmission rates between Q1 2018 and Q1 2019.
For Valley Home Care, which has been in the telehealth game since 2005, Health Recovery Solutions’ proven technological capabilities made the company an attractive partner.
“We were looking for vendors that implemented 4G and Bluetooth opportunities,” Elaine Davis, tele-management clinical coordinator at Valley Home Care, told HHCN. “They were very excited about working with us and building platforms that we would be interested in. Their equipment is easy to use and that was also part of it.”
Valley Home Care’s telehealth program includes a 4G tablet that is pre-loaded with Health Recovery Solutions’ remote patient monitoring software, which pairs with Bluetooth biometric devices. These devices enable patients to record their vital signs on a daily basis.
The tech also allows collaborating clinicians to be able to track patient vitals, communicate via video and respond to patients that are high risk.
“Being able to use video visits, being able to see a patient through a tablet and being able to intervene has really worked out for them,” Bauer said. “The other part is having the newest biometric devices readily available so Valley [Home Care] can take action if they are out of parameters.”
Before partnering with Health Recovery Solutions, Valley Home Care had to work with equipment that wasn’t as “patient-friendly,” took time to install and carved out a great deal of space in a home.
“With one of our older vendors, there was a very big application process,” Davis said. “You had to load a card, insert it into the monitor, then you had to bring the equipment to the home, hook it up into the person’s cable. The installation of the equipment was a lot, and took up a lot of room in the patients home and used their phone line.”
Historically, hospital readmissions have been relatively common in the U.S. In fact, they cost Medicare about $26 billion annually, according to a study published in June in the Annals of Internal Medicine.
Health Recovery Solutions devices are not reimbursed through Medicare.
Instead, Valley Home Care stresses the importance of investing in tools that will elevate their care and prevent hospital readmissions for older adults, pointing to the fact that it allows them to act faster and oversee a large number of people.
“When you have telemonitor in the home and you are getting blood pressure, a pulse oximetry reading, an oxygen saturation reading and daily information about how they are feeling, you are able to access 100 patients a day via monitoring,” Davis said. “In comparison, a nurse out in the field might be seeing between four and six patients a day.”
Last year, Valley Home Care achieved a 30-day all-cause hospital readmission rate of 6.25%. Following that successful experience with Health Recovery Solutions, Valley Home Care has continued to grow its telehealth program, treating over 260 patients in the first three months of 2019 alone.
Nationally, the use of telehealth services has increased drastically in recent years. From 2014 to 2018, the use of non-hospital-based provider-to-patient telehealth grew 1,393%, according to a recent report from FAIR Health, an independent nonprofit that collects data for and manages that nation’s largest database of privately billed health insurance claims.
In part, that increase can be traced back to many of the actions that the Centers for Medicare & Medicaid Services (CMS) has taken in recent years.
In April, for example, CMS finalized a set of policies designed to expand the use of in-home telehealth benefits under the Medicare Advantage program. Traditionally, CMS has largely restricted telehealth reimbursement to clinical settings in rural areas, with only a few exceptions.