Opportunities for Health Systems to Leverage Digital for Value Based Care: Lessons from the AAMC – Manatt Telehealth Learning Collaborative

By Allie Levy Chafetz (Manatt Health), Katie Reget (AAMC) and Jared Augenstein (Manatt Health)

Organizations with a significant portion of their population in value based arrangements are in a unique position to benefit from digital and home-based care. Without the limitations of operating in a fee-for-service environment, organizations can test and implement programs that leverage digital modalities to help patients access the right care at the right time while also creating efficient and scalable care models that prioritize in-person capacity for those that need that level of care and enable timely interventions for patients with chronic or acute care issues. Health systems focused on value based care have the incentives in place to innovate on ways to keep patients healthy and out of the hospital – and digital care can facilitate.

Remote Monitoring for Chronic Disease: Ochsner Health, a 40-hospital health system based in New Orleans, Louisiana, ran a pilot program providing access to digital medicine with remote patient management to improve outcomes for Medicaid patients with chronic diseases including Type 2 diabetes and high blood pressure. Recent pilot data shows that the pilot helped almost half of the “out-of-control” hypertension patients get under control in 90 days and 59% of patients gain control of their diabetes. Remote monitoring programs such as these support value based care by reducing preventable ED visits and/or hospital admissions.

Home Based Care: Geisinger, an 11-hospital health system based in Danville, Pennsylvania, has a home care program, “Geisinger at Home”, which helps the integrated health system and health plan save money by reducing ED visits and unnecessary hospital admissions. By helping patients access care in the home, including home based assisted telemedicine, the patients in these programs experience 36% lower hospitalization rates and a 20% decrease in ED visits.  Geisinger has now expanded to virtual urgent care. Geisinger’s value based model with the health plan encourages it to innovate with new and digitally enabled models of care.

Hospital-at-Home: Brigham and Women’s Hospital studied the impact of patients enrolled in its hospital-at-home programs. In its program, patients receive home visits from clinicians supplemented by remote monitoring, video and other digital means. Patients in the randomized controlled trial experienced a 38% decrease in costs per acute episode as a result of participation in the program. Brigham’s leadership shares that the home program is part of its focus on moving its care model toward value based care. 

There is still a lot to learn – each health system will experiment with care models and programs that serve the needs of their patients and their greatest challenges as an organization. As organizations shift toward more value based care models, the opportunity to thoughtfully integrate telehealth is significant. These three examples – remote monitoring, home based care and hospital-at-home – highlight just the beginning.