Insurers Curbing Hospital Admissions, Remotely

The Anthem pilot is small, only 18 patients, but Tamaru says he expects to have 100 patients enrolled by this month. He had hoped to reach the century mark sooner, but some candidates for the program, identified early on based on claims data, fell out due to changes in insurance eligibility and others due to disease progression, which left them too sick to participate.

At the end of the one-year trial Anthem will review claims data to see if there has been a reduction in hospitalizations, emergency department visits, and total healthcare costs.

Tamaru says he'd like to see monitoring systems extend to members with diabetes, hypertension, and respiratory conditions. "The key questions are, 'How do you create the clinical responses?' and 'What's the right threshold of alerts?' It's a delicate balance."

The issue for patients is cost. Compliance has been high at Optum and Anthem, both of which cover equipment costs. Studies have found, however, that patients are willing to participate with monitoring programs only as long as they do not have to bear the cost. 

For example, roughly half of patients surveyed by PricewaterhouseCoopers' Health Research Institute said they would buy mobile technology for their health. Of those, 18% would like their doctors to monitor their health conditions, but only 11% would care to monitor an existing condition. Respondents expect insurers to cover those costs.

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