Part 4 of 7 - How IoMT is Reducing Readmissions
The Centers for Medicare and Medicaid Services (CMS) began to financially penalize hospitals for excessive readmissions related to heart failure. The Hospital Readmissions Reduction Program (HRRP) was added to the Social Security Act by the Affordable Care Act in 2012, and reduces payments made to hospitals. Up to 3% of regular reimbursements can be held back, which has become a significant expense. According to the CMS, approximately $564 million in payments will be withheld from 2,573 U.S. hospitals in 2018.
According to 2018 abstract from the Journal of the American Heart Association (AHA), heart failure is the primary reason for hospitalization in the United States, and more than 25% of patients hospitalized for heart failure will be readmitted within 30 days.
The AHA cites a three-month study from 2013 that compared telemonitoring care (TMC) and usual care (UC) for heart failure patients who were at high risk for readmission. A nurse-based telemonitoring program was used with 40 patients (who also received two home visits by a nurse) and 80 patients received usual care. The experiment found that the all-cause, 30-day readmission rate for the TMC group was 12.5% compared with 27.5% for the UC group. The heart failure, 30-day readmission rate for the TMC group was 2.5% versus 10% for the UC group. The decrease in heart failure readmissions also reduced the CMS penalty by roughly $118,400.
Even studies using mobile apps have reported similar results. In 2014, a Mayo Clinic study found that patients who participated in cardiac rehab, along with using smartphone apps to keep a record of their weight and blood pressure, lowered both cardiovascular risk factors and 90-day readmissions. Patients who used the apps and rehab treatment combination had a readmission rate of 20%, compared to 60% of patients who only completed rehab.