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Problem Tech Solves
Tech Brief
For too long, the parts of the health care journey that happen outside the doctor’s office or hospital have been fragmented, manual, and unable to meet the entirety of the patient’s needs. The result? Too many people are being directed to expensive, ineffective facility-based care without proper oversight. This often leads to patient dissatisfaction and costly complications that could have been avoided with proper care coordination. Polling shows that 72 percent of consumers would prefer to recover at home versus a medical facility following a major medical event, and 80 percent of patients discharged to a skilled nursing facility could have had the same or better outcomes at home. The best path forward is a home-first approach that creates a more coordinated ecosystem, serving patients comfortably, successfully, and with lower costs than in a facility. CareCentrix developed HomeFirst Analytics. Using predictive analytics, we can coordinate care for members when returning home from the hospital to optimize care transitions, improve quality, and enhance timeliness. Our platform makes it easier for providers and health plans to collect real-time insights into what’s happening in the home so they can intervene earlier and avoid costly complications. This automated approach to coordinating patient care to the home reduces overall cost for both patient and provider.
Tech Differentiators
The HomeFirst Analytics model is unique in healthcare due to its consumer focused design. The application was designed by a consumer app design agency with the sole focus of making the user interface simple and attractive. Healthcare data is notoriously complex, and adding AI and personalized social determinants of health to the mix only makes the output more difficult to understand. Every health tech company says they have artificial intelligence, but the key to adoption is focusing on usability. The HomeFirst app is designed in dark mode because it’s primarily used in hospitals with bright fluorescent lighting. The application uses simple dials to show complex model recommendations and light up buttons to indicate risk factors such as if a member lives alone or has medication adherence challenges. The AI sophistication is shown not by overcomplicating the screens, but by offering reporting on the models performance. CareCentrix made the choice to not overwhelm the user with information to impress the user, but instead shows off model performance through model transparency. Other models in the space require the patient or the hospital to answer 20 or 30 questions to get a recommendation. CareCentrix instead built broad datasets that answer these factors automatically, and then presents the answers to the user to edit as they see fit, making the app much faster to use. While the model performance does represent a breakthrough, the up to 50% cost reduction in post-acute care utilization is due to the usability of the application.
Validation
In March 2021, independent healthcare research and consulting firm Avalere released an analysis of the CareCentrix model that compared a Medicare Advantage population managed by CareCentrix to a statistically similar non-CareCentrix managed cohort. From this study, researchers found CareCentrix lowered the total cost of care, improved outcomes, and reduced hospital readmissions and emergency department visits. The Avalere study found that the total cost of care for Medicare Advantage members was 44 percent lower in the CareCentrix cohort during the initial 90 days following discharge. Total cost of care savings even extended beyond the 90-day CareCentrix post-acute care management program; 12 months after discharge, the CareCentrix cohort was 27 percent less expensive than the non-CareCentrix cohort. The study found that CareCentrix’s readmission rates were up to 22 percent lower during the initial 30-, 60-, and 90-day periods following discharge. There was also a 21 percent reduction in emergency department visits compared to the baseline pre-discharge emergency visits, and a 71 percent reduction in skilled nursing facility expenditures following discharge. The importance of HomeFirst Analytics is also further solidified, as studies have shown that when patients follow the recommended care path outlined using HomeFirst Analytics, their rate of hospital readmission decreases by 11 percent, indicating a dramatic reduction in total cost of care while increasing patient health outcomes and comfort. By leveraging predictive analytics and providing a comprehensive set of tools that help manage the entire patient journey, CareCentrix achieves significant cost reductions and helps more care take place in the home.
