SeniorBridge Partner, Metropolitan Health Networks (MetCare), Announces Results of its Work with SeniorBridge: 2 in 3 Hospital Admissions Averted and Care Costs Cut in Half
In addition to working directly with families, SeniorBridge is proud to work with health plans, physician groups and hospitals to reduce hospitalizations, hospital readmissions and emergency room visits among individuals with chronic conditions. Through our holistic in-home care management provided by a specially trained team of licensed nurse practitioners, nurses and social workers, we consistenly deliver results for payers and providers with whom we partner.
To learn more, read the press release:
Two in Three Hospital Admissions Averted and Care Costs in Half in a One-Year Study of High-Risk Medicare Members Enrolled in Metropolitan’s Medical Home Model of Care with SeniorBridge Care Management
BOCA RATON, FL and NEW YORK, NY, June 19, 2012 – Metropolitan Health Networks, Inc. (NYSE: MDF), a leading provider of health care services in Florida, in conjunction with SeniorBridge, a leading national care management company, today announced results of a study of the impact and effectiveness of combining the company’s Patient Center Medical Home (PCMH) model of care with the in-home care management services of SeniorBridge for older adults with complex health care needs.
The program, aimed at keeping seniors — particularly those who are chronically ill — from repeatedly being hospitalized, is designed to improve the health of vulnerable seniors while saving Medicare money. Participants in the study were among MetCare’s top 5% most chronically ill and costly customers as defined by total medical claims expense in the prior 12-month period.
“The results of the SeniorBridge pilot gave us plenty of reasons to be excited.
We experienced a 71% reduction in total hospital admissions, a 54% reduction in total ER visits and a 48% savings in the total program,” stated Jose Guethon, MD MBA, Metropolitan’s President and Chief Operating Officer.
In addition to these utilization and financial results, a satisfaction survey of the customers enrolled in the program indicated that 100% of those who responded strongly agreed that the care management program met their expectations, and 85% said that they strongly agree that the program also improved their experience with MetCare.
“As a national leader in health care management of chronically ill seniors, we are excited about the potential of these data to further define successful care management approaches for patients with complex medical conditions and functional limitations
and to fundamentally change how care is provided for the most frail seniors in our health system,” said Eric C. Rackow, MD, President and CEO of SeniorBridge.
“These findings are clear evidence that SeniorBridge's care management model - in conjunction with MetCare's Patient Center Medical Home - keeps individuals at high risk for hospitalization well at home, where they want to be, while substantially cutting the cost of care."
Increased Interactions Lead to More Accurate Capture of Health Conditions and Clinical Diagnoses:
“By significantly increasing the frequency of interactions with our customers, the MetCare SeniorBridge program also provided additional opportunities to more accurately capture their health conditions, which impacts the Medicare Risk Adjustment scores,” continued Guethon.
“These results make a compelling story for expanding the program of home-based care management across a larger population of our at-risk customers. There is real value in meeting our customers in their homes alongside their caregivers. By making frequent, face-to-face contact, the SeniorBridge care managers were able to develop relationships on a deeper level with our customers in a short period of time. During these visits the care managers were able to witness the challenges our customers face living independently, as well as their self-care and self-management. Additionally, they were able to identify barriers to care and functional limitations impacting outcomes,” Guethon added.
In-home Care Delivers Critical Feedback in the Care of the Elderly:
Assessments conducted in a physician’s office are limited in many ways including: time constraints placed on the providers, the artificial environment or setting of an exam room, inability of office-based clinicians to adequately determine a patient’s risks at home, and the impracticality of frequent supervision and monitoring. Therefore, an important aspect in the delivery of health care is the care of a patient in their home, and this is particularly important in the case of the elderly. Despite this understanding, much of the focus of health care services and its resources are allocated to acute care settings such as hospitals, and sub-acute settings such as nursing homes and physician offices.
Guethon concludes, “The in-home support provided by the SeniorBridge team during the pilot also gave us critical information and feedback that we could simply not know, even through frequent office visits with our customers.
These included nutritional assessments and dietary compliance and medication reconciliation. While in-home care can never be replaced, telephonic management, supported by the availability of an in-home evaluation, has proven to be a powerful combination and a scalable resource. We will continue developing our customer outreach units based on lessons learned from this pilot.”
Launched on August 1, 2010, the one-year program involved one hundred and four (104) customers who, upon enrollment, received a comprehensive health assessment including evaluation of their medical conditions and functional capacity by a SeniorBridge nurse and/or social worker care manager. Thereafter, SeniorBridge care managers made one-hour-long weekly in-home visits to coordinate care based on the initial assessment, plan, and ongoing observation.
Care management activities included:
• Patient and family education about illnesses, treatments and self-care
• Medication reconciliation
• Behavioral counseling
• Coordination of care with physicians, other health care providers and community resources
• Support during transitions from hospital or emergency room to home
• Home safety evaluation
• Nutritional advice
• Non-directive counseling about end-of-life options
• Obtaining medication from the pharmacy
• Accompaniment to physician office and laboratory visits
• 24/7 on-call availability of a nurse care manager for emergency problems
The integrated care management system involved a team of actively engaged health care professionals coordinating and delivering care to patients across the care continuum. This team included physicians, nurses, nurse and social worker care managers, home health nurses, therapists, clinical pharmacists, medical assistants, home health aides, and management professionals.
Weekly rounds were established to discuss program matters including clinical problems, opportunities, risks, and results. This close interaction and communication between the MetCare PCMH staff and SeniorBridge care managers were important success factors.
About Metropolitan Health Networks, Inc.:
Metropolitan is a growing health care company that provides and coordinates comprehensive health care services for Medicare Advantage, Medicaid, and other customers in Florida through its primary care-centric businesses, MetCare of Florida, Inc. and Continucare Corporation. Metropolitan currently owns and operates 33 medical centers and contracts with a network of independent primary care practices. To learn more about Metropolitan Health Networks, Inc. please visit its website at www.metropolitanhealthnetworks.com.
SeniorBridge is a leading national care management company with an 12-year heritage in helping people cope with the challenges of complex chronic illnesses such as congestive heart failure, chronic obstructive pulmonary disease, Parkinson’s disease, and Alzheimer’s disease. The company’s 44 offices and national care management network works with families, physicians, hospitals and health plans to address the total well-being of its clients through a comprehensive process of care assessment, planning, coordination and advocacy. The company is headquartered in New York City and benefits from the support of its advisory board of internationally known experts in geriatrics. For more information about SeniorBridge, please visit its website at www.seniorbridge.com
Forward Looking Statements:
Except for historical matters contained herein, statements made in this press release are forward-looking and are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Without limiting the generality of the foregoing, words such as “may”, “will”, “to”, “plan”, “expect”, “believe”, “anticipate”, “intend”, “could”, “would”, “estimate”, or “continue” or the negative other variations thereof or comparable terminology are intended to identify forward-looking statements.
Investors and others are cautioned that a variety of factors, including certain risks, may affect our business and cause actual results to differ materially from those set forth in the forward-looking statements. These risk factors include, without limitation: (i) our ability to successfully implement the changes required to achieve improved patient outcomes, reduced hospital admissions for our customers, reduced costs for our organization; or (ii), our ability to expand a program of home-based care management across a larger population of our at-risk customers. Metropolitan is also subject to the risks and uncertainties described in its filings with the Securities and Exchange Commission, including its Annual Report on Form 10-K for the year ended December 31, 2011, its Quarterly Report on Form 10-Q for the quarters ended March 31, 2012.