AMC Health Offers First Money-Back Guarantee To Reduce 30-Day Readmissions By Double Digits Within 90 Days

Guarantee based on implementation of Geisinger-tested post-discharge transition of care protocol

AMC Health, a leading provider of telehealth solutions, recently announced that it will offer hospitals, health plans, accountable care organizations (ACOs), home health agencies and other customers a money-back guarantee on their multi-faceted program to reduce hospital readmissions for high-risk patients. This guarantee offers a full refund if readmissions don't decline by at least 10 percent within 90 days of deployment using a proven interactive voice response (IVR) program with case management initially deployed by the Geisinger Health Plan (GHP) and AMC Health. The program enabled GHP to decrease all-cause 30-day risk of readmissions among Medicare beneficiaries by 44 percent, with actual readmissions reduced by 19.5 percent over a two-year period when compared to a control group that received case management alone.

According to a New England Journal of Medicine study, nearly one in five Medicare patients are readmitted within a month after release from a hospital, costing the Centers for Medicare and Medicaid Services (CMS) $17.4B per year. The CMS and a growing number of commercial payers penalize hospitals for excess readmissions, which has made reducing 30-day readmissions a financial imperative for hospitals, health plans, ACOs, and home health organizations. On Oct. 1, 2012, CMS instituted penalties equaling up to 1 percent of Medicare receipts for more than 2,000 hospitals that readmitted too many patients with pneumonia, heart attacks and heart failure. CMS will ratchet up the pressure on hospitals by expanding the number of covered conditions from three to eight on Oct. 1, 2013, and increasing the maximum penalty to 2 percent on Oct. 1, 2014 and up to 3 percent on Oct. 1, 2015.

"Based on our successful track record and the knowledge and experience we have gained during the past decade, we are confident we can deliver the care coordination solutions and support services needed to provide consistent, significant reductions in 30-day readmissions that will more than offset the cost of our program. We're also motivated to offer a full refund because we believe in creating a true partnership with our customers and work closely with them to achieve success," explains Nesim Bildirici, AMC Health's president and CEO. "This guarantee is an example of how we 'walk the walk' not just 'talk the talk' to help ease our customers' transition to value-based purchasing by improving patient care throughout the care continuum and strengthening their financial outlook."

AMC Health has implemented more than 75 programs to minimize hospital admissions, including this program's post-discharge transition of care protocol that includes a combination of an IVR program with case management. Discharged patients will receive IVR telephone calls. Based on patient responses, AMC Health's telecare managers will identify gaps in care and screen for conditions that put individuals at risk of re-hospitalization. A case manager will contact clients when problems arise that require the involvement of a clinician.

AMC Health will refund 100 percent of all costs incurred during the first 90 days of the program if the 30-day readmission rate doesn't decline by at least 10 percent compared to a risk-matched reference population receiving the usual care.

"As studies published in peer-reviewed journals have shown, AMC Health's telemonitoring programs help provide high-quality care without a major capital investment and with near-real-time, quantifiable results," states Bildirici. "To thrive in the face of emerging market forces--including the shift from volume-based to value-based reimbursement--which will directly impact their finances and reputations, stakeholders must incorporate post-acute care into their care plans and ensure that it's managed properly. The money-back guarantee is our way of demonstrating our commitment to partnering with customers, contributing to improvements in patient care and safety, and differentiating ourselves from the growing number of companies that claim they can provide effective, affordable telehealth solutions, but can't always deliver what they promise."

About AMC Health
With headquarters in New York City, AMC Health is a leading provider of telehealth solutions that provide customized, scalable, cost-effective programs that assist organizations serving at-risk populations. These programs deliver clinically actionable information that enhances care coordination, improves patient outcomes and reduces the overall cost of healthcare.  For more information, visit www.amchealth.com.