The Impact of a Remote Patient Care Program on Health Care Costs and Utilization Among Medicare Patients With Chronic Disease

David I. Feldman MD, MPH , Spencer Reynolds MBA , Sarine Babikian PhD , Brian D. Stein MD, MS , Jessica Schlicher MD, MBA , Eve Cunningham MD, MBA , Theodore Feldman MD , Randall Curnow MD, MBA , Jing Zheng MS , Puneet Budhiraja MS , Marat Fudim MD, MHS
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Abstract

Remote patient monitoring coupled with technology-enabled, guideline-directed clinical care—or remote patient care (RPC)—has consistently led to improved outcomes for Medicare patients with chronic diseases. However, the ability for RPC to drive reductions in total cost of care and health care utilization is limited. We sought to determine whether an RPC program can reduce health care costs and utilization. Using patient-level Medicare claims data, a difference in difference analysis was conducted to assess the impact of an RPC program compared with a propensity score–matched control group on total health care costs and resource utilization over a 12-month period following program activation. The retrospective analysis included patients enrolled into an RPC program from July 1, 2022 to October 31, 2023 from primary care and cardiology clinics across 15 states. The RPC program included a group of clinicians who monitored and triaged vitals and conducted clinical visits using standardized clinical protocols to facilitate guideline-directed clinical interventions. We compared 5872 patients enrolled in an RPC program to 11,449 eligible propensity score–matched control patients. RPC resulted in a statistically significant reduction in total cost of care (−$1302 per patient per year; P<.01), which was driven primarily by a reduction in inpatient costs (−$1428 per patient per year; P<.01). Patients enrolled in the RPC program also had a lower rate of hospitalizations (−23 vs +41/1000 patients/y; 27% reduction; P<.01). These data highlight the potential for a nationwide RPC program to lead to significant cost savings and a reduction in health care utilization among Medicare patients at scale.
远程病人护理计划对医疗保健费用和慢性病患者利用的影响
远程患者监测与技术支持、指导的临床护理(或远程患者护理(RPC))相结合,一直为患有慢性病的医疗保险患者带来改善的结果。然而,RPC推动降低医疗总成本和医疗保健利用的能力是有限的。我们试图确定RPC程序是否可以降低医疗保健成本和利用率。使用患者层面的医疗保险索赔数据,进行了差异分析,以评估RPC计划与倾向得分匹配的对照组在计划启动后12个月内对总医疗保健成本和资源利用的影响。回顾性分析包括从2022年7月1日至2023年10月31日在15个州的初级保健和心脏病诊所参加RPC项目的患者。RPC项目包括一组临床医生,他们监测和分类生命体征,并使用标准化的临床协议进行临床访问,以促进指导临床干预。我们比较了5872名参与RPC项目的患者和11449名符合倾向评分匹配的对照患者。RPC在统计上显著降低了总护理成本(每位患者每年- 1302美元;P< 0.01),这主要是由于住院费用的降低(每位患者每年- 1428美元;P< 0.01)。参与RPC计划的患者住院率也较低(- 23 vs +41/1000患者/年;减少27%;P< 0.01)。这些数据强调了全国范围内的RPC计划的潜力,以导致显著的成本节约和减少医疗保健利用在医疗保险患者的规模。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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