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By Dirk G. Soenksen CEO and Co-founder Ceresti Health |
Reducing hospitalizations for frail elderly members is a major challenge for Medicare Advantage payers and providers. That’s because frail elderly incur 70% of all hospitalizations and drive more than 50% of total medical costs. Frail elderly have complex care needs that include a 30% prevalence of Alzheimer’s/dementia, multiple chronic conditions and challenges with completing activities of daily living. These self-management challenges limit their ability to participate in traditional care management programs; e.g., those established for patients with diabetes and congestive heart failure. Unsurprisingly, frail elderly have medical costs that are three times greater than those who are not frail. There costs are largely attributable to avoidable hospitalizations.
The key to avoiding any hospitalization is to detect and address a change in condition before it worsens. For example, a change in the frequency of urination signals the early stages of a urinary tract infection (UTI). If treated early, UTIs are readily managed. If left untreated, UTIs can lead to sudden changes in behaviors, falls, sepsis and other complications that frequently require hospitalization. An untreated UTI can trigger a cycle of deterioration that drives medical costs and results in a decline in the health status of the members, which in turn increases caregiver burden and compromises aging in place.
How does the family caregiver fit into this? The majority of those who are frail have a family caregiver (spouse, adult child) or someone else helping them with their care. Family caregivers have a superpower: they have frequent, often 24/7 visibility, into their loved one’s health and are motivated to help. They are thus uniquely able to monitor their loved one for changes in condition and can access primary care, thus breaking the cycle of deterioration.
Ceresti set out to unlock the superpower of family caregivers with its Digital Caregiver Activation Platform (DCAP). We offer caregivers a “free” program and deliver the payer/provider who underwrites the program a return on investment (ROI) based on cost savings. Ceresti’s DCAP leverages data and predictive analytics to activate and support family caregivers via a personalized program of education, resources, social-worker-led coaching, and caregiver-enabled remote monitoring of their loved one; all delivered via a dedicated tablet that is shipped to the caregiver’s home.
Validation Institute reviewed claims-based data from 164 caregiver/patient dyads that were enrolled into Ceresti’s DCAP. Utilization and cost outcomes were compared against a propensity-matched comparison group of 393 patients. An 80% reduction in hospitalizations (p=0.02) and a 53% reduction in medical costs (p=0.003) were realized over a 6-month study period. The magnitudes of these savings underscores the superpower of family caregivers.
By partnering with Ceresti, payers and providers can offer family caregivers an evidence-based playbook to improve quality of life, sustain aging in place and avoid the trauma of unnecessary hospitalizations, while realizing a meaningful ROI.
To learn more contact sales@ceresti.com.
Read Ceresti’s Savings Validation Report HERE.
