Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment

Background: Participation in cardiac rehabilitation (CR) is recommended for all patients with coronary artery disease (CAD) following hospitalization for acute coronary syndrome or stenting. Yet, few patients participate due to the inconvenience and high cost of attending a facility-based program, f...

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Autores principales:	Arash Harzand, Aaron C. Weidman, Kenneth R. Rayl, Adelanwa Adesanya, Ericka Holmstrand, Nicole Fitzpatrick, Harshvardhan Vathsangam, Srinivas Murali
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	mobile health virtual care cardiac rehabilitation economic impact coronary artery disease Medicine R Public aspects of medicine RA1-1270 Electronic computers. Computer science QA75.5-76.95
Acceso en línea:	https://doaj.org/article/9668cbb737d2469d99df7706a8cc26cd
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spelling	oai:doaj.org-article:9668cbb737d2469d99df7706a8cc26cd2021-11-30T19:50:25ZRetrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment2673-253X10.3389/fdgth.2021.678009https://doaj.org/article/9668cbb737d2469d99df7706a8cc26cd2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fdgth.2021.678009/fullhttps://doaj.org/toc/2673-253XBackground: Participation in cardiac rehabilitation (CR) is recommended for all patients with coronary artery disease (CAD) following hospitalization for acute coronary syndrome or stenting. Yet, few patients participate due to the inconvenience and high cost of attending a facility-based program, factors which have been magnified during the ongoing COVID pandemic. Based on a retrospective analysis of CR utilization and cost in a third-party payer environment, we forecasted the potential clinical and economic benefits of delivering a home-based, virtual CR program, with the goal of guiding future implementation efforts to expand CR access.Methods: We performed a retrospective cohort study using insurance claims data from a large, third-party payer in the state of Pennsylvania. Primary diagnostic and procedural codes were used to identify patients admitted for CAD between October 1, 2016, and September 30, 2018. Rates of enrollment in facility-based CR, as well as all-cause and cardiovascular hospital readmission and associated costs, were calculated during the 12-months following discharge.Results: Only 37% of the 7,264 identified eligible insured patients enrolled in a facility-based CR program within 12 months, incurring a mean delivery cost of $2,922 per participating patient. The 12-month all-cause readmission rate among these patients was 24%, compared to 31% among patients who did not participate in CR. Furthermore, among those readmitted, CR patients were readmitted less frequently than non-CR patients within this time period. The average per-patient cost from hospital readmissions was $30,814 per annum. Based on these trends, we forecasted that adoption of virtual CR among patients who previously declined CR would result in an annual cost savings between $1 and $9 million in the third-party healthcare system from a combination of increased overall CR enrollment and fewer hospital readmissions among new HBCR participants.Conclusions: Among insured patients eligible for CR in a third-party payer environment, implementation of a home-based virtual CR program is forecasted to yield significant cost savings through a combination of increased CR participation and a consequent reduction in downstream healthcare utilization.Arash HarzandAaron C. WeidmanKenneth R. RaylAdelanwa AdesanyaEricka HolmstrandNicole FitzpatrickHarshvardhan VathsangamSrinivas MuraliFrontiers Media S.A.articlemobile healthvirtual carecardiac rehabilitationeconomic impactcoronary artery diseaseMedicineRPublic aspects of medicineRA1-1270Electronic computers. Computer scienceQA75.5-76.95ENFrontiers in Digital Health, Vol 3 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	mobile health virtual care cardiac rehabilitation economic impact coronary artery disease Medicine R Public aspects of medicine RA1-1270 Electronic computers. Computer science QA75.5-76.95
spellingShingle	mobile health virtual care cardiac rehabilitation economic impact coronary artery disease Medicine R Public aspects of medicine RA1-1270 Electronic computers. Computer science QA75.5-76.95 Arash Harzand Aaron C. Weidman Kenneth R. Rayl Adelanwa Adesanya Ericka Holmstrand Nicole Fitzpatrick Harshvardhan Vathsangam Srinivas Murali Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment
description	Background: Participation in cardiac rehabilitation (CR) is recommended for all patients with coronary artery disease (CAD) following hospitalization for acute coronary syndrome or stenting. Yet, few patients participate due to the inconvenience and high cost of attending a facility-based program, factors which have been magnified during the ongoing COVID pandemic. Based on a retrospective analysis of CR utilization and cost in a third-party payer environment, we forecasted the potential clinical and economic benefits of delivering a home-based, virtual CR program, with the goal of guiding future implementation efforts to expand CR access.Methods: We performed a retrospective cohort study using insurance claims data from a large, third-party payer in the state of Pennsylvania. Primary diagnostic and procedural codes were used to identify patients admitted for CAD between October 1, 2016, and September 30, 2018. Rates of enrollment in facility-based CR, as well as all-cause and cardiovascular hospital readmission and associated costs, were calculated during the 12-months following discharge.Results: Only 37% of the 7,264 identified eligible insured patients enrolled in a facility-based CR program within 12 months, incurring a mean delivery cost of $2,922 per participating patient. The 12-month all-cause readmission rate among these patients was 24%, compared to 31% among patients who did not participate in CR. Furthermore, among those readmitted, CR patients were readmitted less frequently than non-CR patients within this time period. The average per-patient cost from hospital readmissions was $30,814 per annum. Based on these trends, we forecasted that adoption of virtual CR among patients who previously declined CR would result in an annual cost savings between $1 and $9 million in the third-party healthcare system from a combination of increased overall CR enrollment and fewer hospital readmissions among new HBCR participants.Conclusions: Among insured patients eligible for CR in a third-party payer environment, implementation of a home-based virtual CR program is forecasted to yield significant cost savings through a combination of increased CR participation and a consequent reduction in downstream healthcare utilization.
format	article
author	Arash Harzand Aaron C. Weidman Kenneth R. Rayl Adelanwa Adesanya Ericka Holmstrand Nicole Fitzpatrick Harshvardhan Vathsangam Srinivas Murali
author_facet	Arash Harzand Aaron C. Weidman Kenneth R. Rayl Adelanwa Adesanya Ericka Holmstrand Nicole Fitzpatrick Harshvardhan Vathsangam Srinivas Murali
author_sort	Arash Harzand
title	Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment
title_short	Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment
title_full	Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment
title_fullStr	Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment
title_full_unstemmed	Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment
title_sort	retrospective analysis and forecasted economic impact of a virtual cardiac rehabilitation program in a third-party payer environment
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9668cbb737d2469d99df7706a8cc26cd
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Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment

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