I. Executive Summary
Visiting Nurse Health System (VNHS) is experiencing difficulty in quantifying the benefits of their telemonitoring services used to provide care to patients recently discharged from hospitals. While the company believes these services provide real value to the patients, hospitals and insurance companies, VNHS is worried about the ability to provide future investment in the technology given the tenuous healthcare reimbursement environment. To continue to grow its telemonitoring services, VHNS should:
• Assess patient specific effectiveness of telemonitors
• Quantify the advantage of telemonitoring to insurance companies
• Reduce the technology’s accessibility limitations
• Find alternatives to the telemonitoring service
• Create and implement a marketing strategy
In order to accomplish these goals, we recommend the following: Develop an electronic means of assessing telemonitoring usage and compliance with final clinician approval for removal of telemonitor. • This will increase the effectiveness of telemonitors by eliminating patients who do not use telemonitors effectively. • Automated analysis will be quick and simple.
Lobby with FDA and government agencies to pass new act/regulation which forces insurance companies to reimburse for telemonitoring devices • Benefits the entire health care industry and reduces cost at multiple levels. (Insurance companies, patients and hospitals) Create secure website and computer application to compliment Health Buddy. • Gives patients a variety of choices to transmit data
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• Inexpensive and effective, with no need to upgrade Health Buddy Integrate Health Buddy with alternative technologies • Having options to do telemonitoring via internet, mobile application and voice based automated telephone systems will allow VNHS to keep the cost low. Create a marketing strategy that targets hospitals and insurance companies that do not have a preferred partner status with VNHS. • Acquiring preferred status has a direct correlation to the future success of VNHS • By targeting specific hospitals and insurance companies, the marketing message can be tailored to each individual client.
II. Overview
Visiting Nurse Health System (VNHS) is an accredited nonprofit home health company located in Atlanta, GA. As a home health company it depends on patient reimbursement from Medicare, Medicaid, and private insurance companies to fund a majority of its operations. As the Center for Medicare and Medicaid Services (CMS) moved to a flat fee for reimbursement and also implemented initiatives to reduce the amount of hospital readmissions due to preventable causes, healthcare organizations are under increased pressure to lower costs while also delivering high quality health care. One way VNHS is trying to become more efficient and meet CMS goals is to use telemonitoring devices to assess a patient’s health remotely.
By remotely monitoring patients, VNHS can reduce clinician visits to the patient location as well as monitor potentially important health information that can prevent the patient from having to be readmitted to the hospital. The Health Buddy telemonitoring device has the potential to improve patient outcomes while reducing VNHS cost. The downside is that while CMS encourages the use of telemonitors, VNHS does not receive reimbursement from CMS or insurance companies when it purchases telemonitors. With a limited supply of telemonitors and a significant cost associated with each, VNHS must decide if telemonitoring is the most cost effective way to increase patient health outcomes while also keeping its costs low.
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