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CareAtHand @ Aging2.0 Boston 9/17/2013

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CareAtHand @ Aging2.0 Boston 9/17/2013

  1. 1. Empowering $10 per hour lay caregivers to prevent $10,000 hospitalizations © Care at Hand Andrey Ostrovsky, M.D. CEO, Co-Founder andrey@careathand.com 443-857-8199 1
  2. 2. Medicare-Medicaid Dual Eligibles are disproportionately high utilizers of acute care hospitals 2 Care at Hand e: CMS Policy Brief: Dual Eligible Beneficiaries and Potentially Avoidable Hospitalizations. Segal M. 2011. Jencks SF, er al. NEJM 2009; 360 (14):1418 1428.‐ Duals are hospitalized twice as often as general Medicare patients © Care at Hand 1 in 4 Duals are readmitted every month
  3. 3. Duals account for a disproportionate share of Medicare and Medicaid spending 3 Care at Hand ce: Jacobson G, Neuman T, & Damico A. Medicare’s Role for Dual Eligible Beneficiaries. APRIL 2012. Kaiser Foundation. © Care at Hand
  4. 4. Duals spending isn’t just on hospitalizations Top PMPM Costs for Duals 4 Care at Hand e: Milligan C. Innovations in Integrated Care: New Opportunities to Better Serve Dual Eligibles. February 23, 2011. Hilltop Institute. Medicare Medicaid © Care at Hand
  5. 5. Acute care: largest contributor to Medicare spending Post-acute care: fastest growing cost 5 Care at Hand ce: Chandra et al. Large Increases In Spending On Postacute Care. Health Aff). 2013 May; 32(5): 864–872. Medicare’s expenditures on post acute care increased by 100-250% © Care at Hand
  6. 6. e biggest opportunity to bend cost curve is improving st-acute care 6 Care at Hand RelativeDailyCostof Care Per Capita Health Care Utilization - FFS acute health decline Time © Care at Hand
  7. 7. 7 Care at Hand RelativeDailyCostof Care What if we could utilize existing non-clinical home care providers in a clinically meaningful way? Time Per Capita Health Care Utilization – Managed Care + acute health decline Phone call from care coordinator after CAH alert © Care at Hand
  8. 8. Current standard of home care Lay Caregiver (Home Care Agency) Care Coordinator (Payer) Primary Care Provider Visit Emergency Dept/ Admission Home Visit by Nurse Call into Home by Care Coordinator 8 (Cost to Payer) Care at Hand (Cost to Payer) (Cost to Payer) (Cost to Payer) © Care at Hand
  9. 9. Care at Hand Value Proposition Lay Caregiver Completes Survey (Home Care Agency) Care Coordinator Receives Alerts (Payer) Primary Care Provider Visit Emergency Dept/ Admission Home Visit by Nurse Call into Home by Care Coordinator 9 (Cost to Payer) Care at Hand (Cost to Payer) (Cost to Payer) (Cost to Payer) © Care at Hand
  10. 10. 10 Fewer Frequent Flyers were readmitted after Care at Hand was introduced Care at Hand 42.6% Decrease in 30-day readmissions in addition to CCTP CCTP Alone CCTP + 30-dayReadmissionRate 60/181 (33.1%) 8/42 (19.0%) © Care at Hand
  11. 11. 11 Decrease in Frequent Flyer readmissions impacted overall readmission rate for CCTP program at ESMV Care at Hand 20.6% Decrease in 30-day readmissions among all CCTP enrollees at ESMV CCTP Alone CCTP + 30-dayReadmissionRate 1,643/10,609 (15.5%) 190/1,546 (12.3%) 19.1% baseline 30-day readmission rate among 6 participating hospitals prior to CCTP program starting at ESMV © Care at HandSource: ESMV CCTP Data 2013.
  12. 12. 12 Frequent Flyer admission rate cut in half after Care at Hand Care at Hand 45.9% Decrease in admission rate among frequent flyers in addition to CCTP CCTP Alone CCTP + Admissions/person-year 4.33 2.35 0.57-0.82 admissions/person-year is the typical range for duals; rates in this pilot are higher because sample population is comprised of frequent flyers Source: Milligan C. Innovations in Integrated Care. 2011. Hilltop Institute. CMS Policy Brief: Dual Eligible Beneficiaries. Segal M. 2011 © Care at Hand
  13. 13. 13 Care manager subjective measure of admission prevention highly correlated with CMS claims data Care at Hand Care managers suspected only 8% more admissions than documented by CMS claims data CCTP Admissions Data Care Manager Subjective Documentation PreventedAdmissions 12 13 26 expected admissions after Care at Hand introduced based on pre- intervention admission rate of 4.33 admissions/person- year for 6.0 patient years © Care at HandSource: ESMV CCTP Data 2013.
  14. 14. Care at Hand creates real-time care coordination 14 Care at Hand © Care at Hand
  15. 15. 15 Care at Hand RelativeDailyCostof CareApproximate cost savings from Care at Hand Time = $131,000- © Care at Hand
  16. 16. Next steps: Empower ASAPs/AAAs/CCTP sites to secure more business 16 Care at Hand high value MLTSS = risk-bearing payers + care coordinators + (home care x ) Dual special needs plans Medicare managed care ACOs ICOs Care managers internal to payers Area Agency on Aging (AAA) ASAPs CCTP Sites © Care at Hand
  17. 17. …enabling frail elderly to age in place More important than getting more business or saving tax dollars… 17 Care at Hand © Care at Hand
  18. 18. andrey@careathand.com 18 Thank you! angel.co/care-at-hand © Care at Hand

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