The remote-patient managing programs at Ochsner Health have done such an excellent job of keeping patients healthy that, for those enrolled under value-based care, risk-based contracts, the New Orleans-based, physician-led system has seen a 3-to-1 return on investment (ROI).
“We started how we do lots of things, within our own capitated Medicare Advantage population,” said Sidney “Beau” Raymond, MD, MMM. He is the chief medical officer of Ochsner Health Network, which includes 3,870 physicians with Ochsner Health and other leading Gulf South hospitals and health systems as well as affiliated community physicians.
“We then expanded it to our Medicare Shared Savings Program; therefore, it was available to patients who were in at-risk type contracts,” Dr. Raymond added. “Anything we're doing to decrease total cost of care, was a benefit. So, when we talk about that 3–1 ROI, that's where that is.”
Average per-member, per-year savings equal $2,200 thanks in part to 79% of enrolled members achieving their BP goals after six months and 81% reaching their A1c goals after six months.
Ochsner Health is the largest integrated delivery system in the Gulf South and is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. Raymond spoke during an AMA Integrated Physician Practice Section (AMA-IPPS) education session held as part of the 2024 AMA Annual Meeting in Chicago, and he emphasized that the success was due to remote-patient management, as distinguished from mere monitoring of patients remotely.
The success includes expanding Ochsner Health’s digital Connected Health program under a cardiometabolic disease umbrella and includes a physician-led team with pharmacists and health coaches interpreting data from Bluetooth blood pressure cuffs or glucometers sent directly to the system’s EHR.
“It creates dashboards,” Dr. Raymond said. “We're then looking at that information that's coming in and it's actually signaling people what kind of intervention needs to happen.”
The program features physician-developed algorithms created by cardiologists, lipidologists and endocrinologists to manage blood pressure, lipid disorders and diabetes.
Along with this technological support, the health coaches also know the diet and culture of the local patient population.
“A health coach may get involved because a patient may need a reminder about diet and exercise,” Dr. Raymond said. “For a local issue, maybe they’ll ask them, ‘Did you have a crawfish boil recently? That may be why your blood pressure went up, because it's really high in salt.’ So, they'll engage with the patients and help them along.”
Higher initial cost led to savings
Other outcomes highlighted by Dr. Raymond included these impressive reductions in:
- Emergency department (ED) visits among patients enrolled in the hypertension program—45%.
- Hospital admissions among those in the hypertension program—38%.
- ED visits among patients in the type 2 diabetes program—30%.
- Hospital admissions among patients in the type 2 diabetes program—15%.
“The interesting thing is that the pharmacy cost went up because we got people on the medications that they're supposed to be on, so we got them on the right ones and initial pharmacy cost goes up,” Dr. Raymond said.
“By doing what we're supposed to be doing regarding the right meds and the right treatment and the right engagement, however, people are going to the ER less, people get admitted less,” he added. “That's where the actual benefit comes from. And last time I checked, we really don't want people going to the hospital when we can prevent it."
In the Ochsner Health Network report, “Accelerating Value-Based Care,” which was released last December and listed 2022 economic impacts, it was noted that “value-based care continues to stand out as the clear solution, driving down costs, providing enhanced clinician support, improving patient experiences and outcomes, and rewarding patient-focused care.”
Notable impacts in 2022 included a $2.9 million distribution to participating physicians after saving employers and beneficiaries millions more through Blue Cross and Blue Shield of Louisiana’s Quality Blue gain share program.
High patient satisfaction reported
The net-promoter score measures consumers’ likelihood to recommend a product or service, and Dr. Raymond was happy to report that Connected Health’s 82 score was higher than that of Netflix (68) and Amazon (62).
That result “is pretty cool,” he said. “Patients are very happy with it.”
Dr. Raymond, however, did note one patient who had difficulty with the program at the start.
“A close relative of mine at the start stated, ‘They keep texting me that I need to put in my results,’ and I'm like, ‘Yeah, that's the whole point of the program,’” Dr. Raymond recalled.
“Eventually, he did what he was supposed to do and actually put them in,” he added. “I will say he intentionally does not take readings at certain times of year—such as Mardi Gras—but then he gets back on the wagon afterward.”
Learn more with the AMA Remote Patient Monitoring Implementation Playbook.
