AMC Health helps Humana manage CHF in Medicare population

By Neil Versel

and medicalHealth insurer Humana is turning to telehealth systems provider AMC Health in an effort to keep patients with congestive heart failure out of hospitals, saving money for the payer and improving the quality of life for a high-risk population.

In a pilot launched last month, 450 Humana Medicare Advantage members in Ohio with CHF are receiving A&D Medical Products weight scales and blood-pressure monitors with Bluetooth connections to a custom-developed cellular modem, as well as telephone access to interactive voice response system. The pilot will run about nine months, then Humana will evaluate progress, according to Denise Streible, project manager at Humana Cares, the insurance company's care management arm.

The goal from the payer's perspective is to educate members about the importance of daily measurements of weight and blood pressure. "We ultimately want to prevent readmissions and ER visits," said Streible, a registered nurse, "and maintain quality of life."

Similarly, AMC Health hopes to help patients modify behaviors based on what the devices show, according to Nawaz Jadavji, the Vice President of AMC Health. "If the patient is taking readings at home, they feel more a part of care," Jadavji said.

"The pilot is really a supplement," according to Streible. "It's another tool in the toolbox."

Humana ran a query among its Medicare Advantage population in Ohio to identify high-risk patients and contacted potential participants by telephone. From there, New York-based AMC Health takes over, helping patients set up the devices at home, handles the logistics of the program and provides care coordination services. "It goes beyond technology," Jadavji told MobiHealthNews.

AMC Health clinicians actually do the monitoring. If a patient has a health need other than CHF, AMC Health turns the case over to a Humana care manager.

Jadavji acknowledged that care coordination is a "challenge" in healthcare. "Our goal is to get the data from the patient's home," he said. If the patient is not taking readings, AMC Health can have the IVR system call. In the case of an abnormal value, a nurse gets an alert, who then can have the IVR system call and perform triage by phone.

AMC Health collects data from the home devices and can send the information directly to physicians' electronic health records, thanks to links already built with several major EHR vendors. "We will interface with the patient and the physician's office," Jadavji said.