Proprietary tool identifies best framework for patient recovery after discharge, highlights power of episodes in healthcare transformation
The study verified the effectiveness of a Clinical Decision Support (CDS) algorithm in determining the next optimal site of care for patients discharging hospital while avoiding unintended effects such as increased readmissions , use of emergency services and overall expenses. The algorithm was designed and tested within Remedy’s innovation incubator, Remedy Labs, and is currently used by several Remedy partners through the proprietary Care at the Right Location (CARL) tool.
“Post-acute care spending represents a substantial portion of overall healthcare costs and is growing faster than any other category of spending. It is therefore important that providers think about how they are using these resources, ”said study author and Remedy Medical Director, Win Whitcomb, MD“ The CARL tool is a game-changer for organizations participating in value-based payment models like ACOs and bulk payments where this category represents an opportunity to save, but it is also important for patients who want to recuperate from the comfort of their own homes whenever possible.
Key takeaways from the study include:
- Adherence to the algorithm’s recommended level of care was associated with a decrease in spending of $ 860, fewer readmissions, and unchanged emergency room use over a 90-day episode compared to those where the recommended level of care n was not followed.
- Judicious use of post-acute care resources by the hospital discharge team can be improved by using the decision support algorithm.
- Remedy’s CDS algorithm incorporating cognition, gait, activities of daily living, availability of skilled caregivers, skilled therapy, and skilled nursing needs was assessed in 15,887 patients participating in the pooled payment program of Medicare.
“At Remedy, we’re constantly looking for new ways to increase value, efficiency and health outcomes, and we’ve created something remarkable with CARL,” said Remedy President and CFO Steve Senneff . “Many of our supplier partners are already seeing the benefits of deploying the right resources at the right time, including better patient outcomes and significant savings that can be reallocated to meet other needs. It is the promise of high quality health care and the power to reorganize care around patient episodes. “
This study included a retrospective review of a fee-for-service medicare patient aged 65 and over linked to a database of patients receiving CDS.
The study evaluated patients whose disposition at discharge met the CDS recommendation versus those who did not and patients receiving CDS for disposition at discharge versus those who did not. were not, regardless of the concordance. Results were related to spending over a 90-day episode, 90-day readmissions, and emergency department use not associated with readmission.
Remedy Labs is an innovation incubator that identifies and studies clinical efficiencies used in Remedy’s business lines. Led by our clinicians, Remedy Labs analyzes our massive complaints database to identify the levers that have a real impact on the delivery of care and drive the overhaul of care through shared knowledge to drive innovation in the delivery of care. health through episodes. A central focus of Remedy Labs is the people side of care delivery, with a patient focus and value first, to highlight the impact for patients and providers.
Remedy is the leading healthcare company in the United States, connecting employers, insurance companies, and healthcare systems to deliver more cost-effective care and improved consumer experiences. Remedy provides software and services for healthcare providers and health insurers to organize and fund healthcare around episodes of patient care. The company’s pooled payment network serves Medicare and private insurers and manages more than $ 9 billion in annual health care spending. For more information, visit www.powerofremedy.com.