Medicare benefit plans can benefit from virtual care for cardiovascular disease – Healthcare Blog

By Richard Frank

By relying on virtual cardiometabolic solutions for continuing care, Medicare Advantage can achieve better outcomes, reduce costs, and enhance member satisfaction — and improve star ratings in the process.

Medicare Advantage is a hot market. registration is Climbs steadily Medicare Advantage (MA) members now make up half of Medicare’s population. Although members continue to scale, competition among mine business plans remains intense and employee turnover remains high. almost 16% MA members switch plans at least once during their first year, while more than a third Eventually switch by the third year. Neediest Medicare members tend to opt out altogether, impact star ratings.

On top of fierce competition for members, MA plans struggle with ballooning costs as rates of cardiovascular diseases such as diabetes, obesity, and high blood pressure steadily rise. It’s hard to overestimate the impact of cardiovascular disease on our nation’s elderly population — especially since these conditions tend to appear together and worsen with age. We are long overdue in finding more innovative solutions.

Poorly managed cardio-metabolic conditions are major factors leading to MA medical expenses direction and spending, Member dissatisfaction, thus, poor Star performance. But increasingly, virtual care companies are starting to change some of these trends. MA plans should take note.

Virtual care provides value-based pricing and cost-effective interventions

There is no doubt that the costs associated with cardiovascular disease are escalating at an alarming rate. Chronic diseases are responsible for 86% Of total healthcare spending in the United States, most of it is rooted in cardiovascular disorders with an increasing prevalence. more 40% of Americans are obese, which increases the risk of developing diabetes Six times. more than 75% Of the elderly have high cholesterol, and almost half of all adults have high blood pressure less than 25% Put it under control.

While these chronic diseases cost approx 3.7 trillion dollars Annually in healthcare spending and lost productivity, virtual cardiovascular care is making a significant impact to improve health metrics and reduce costs. Many hypothetical companies follow value-based pricing models that focus on results rather than just charging for a service. Some companies even offer guarantees and performance strategies to reduce healthcare utilization in a medically appropriate way. By providing access to health coaches and tools designed to help change behavior, virtual cardiovascular care can prevent unnecessary hospitalization and even work to wean people off expensive medications.

When demand increases for some of these expensive medications (such as GLP-1s for weight loss), virtual heart care companies can offer pre-authorization and a clinically rigorous step-by-step treatment approach to keep costs in check while still delivering meaningful results. Health coaches and registered dietitians help manage medication side effects and guide the behavioral changes needed to maintain results.

Medicare Advantage members value the ongoing support and convenience of virtual care

It’s easy to assume that MAs would be reluctant to use technology-based solutions to improve their health. But research shows the opposite is true. Seniors find convenient and effective virtual care solutions, with more 60% Boomers report success in changing behavior through digital means. since the epidemic, 50% More MAP beneficiaries are using virtual care, and digital health technology use is up overall.

Obesity, diabetes, high blood pressure, and other chronic conditions take a heavy toll on seniors’ health, mobility, pocketbooks, and overall quality of life. They need more help than the actual service providers can provide. By contrast, virtual care:

• Improves access. more than 1 in 5 Older Americans live in rural areas with low access to specialized care. Not attending virtual care is 7.5% vs. 36% For appointments in the office.
• Provides better continuity of care. Care teams made up of physicians, registered dietitians, diabetes educators, health coaches, and therapists are members and efficiently coordinate care.
• Offers easy-to-use tools for success. Remote monitoring devices and app-based software help members track progress and gain more health education through engaging content.
• Cost less than pocket. Virtual care does not require fuel, parking, and public transportation costs for members.

Star ratings drive member attraction and retention

With star performance reviews playing a critical role in attracting and retaining MA members, plans leaders need all hands on deck to meet their marks. With star ratings increasing for their focus on member experience (Consumer Rating for Healthcare Providers and Systems, or “CAHPS”) along with clinical quality as measured by the Healthcare Effectiveness Information and Data Set (HEDIS), MA plans are better off investing in virtual solutions that provide an ongoing caring experience that members value. Member complaints About health plans may have the biggest impact on contract performance, so plans will want to avoid those as much as possible.

Many virtual solutions are designed to completely surround members with specialized care teams to coach through behavioral changes, deliver customized eating plans, teach health literacy skills, and even administer medications – prescribing and prescribing as appropriate. They are very effective at keeping members out of the hospital and enabling people to take charge of their own health.

Medicare Advantage plans can gain a lot from partnering with virtual cardiometabolic solutions that save costs while delivering clinically significant results and put members at the center of care. After all, healthier MA members also make more satisfied MA members.

Dr. Richard Frank is the Chief Medical Officer of Vida Health.