Hearing before the Senate Special Committee on Aging
SAVING DOLLARS, SAVING LIVES:
THE IMPORTANCE OF PREVENTION IN CURING MEDICARE
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HEARING
before the
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
FIRST SESSION
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WASHINGTON, DC
__________
JUNE 30, 2005
STATEMENT OF MR. STEPHEN J. BROWN, PRESIDENT AND CEO, HEALTH
HERO NETWORK, INC., MOUNTAIN VIEW, CA
Mr. Chairman and Committee members, I am Steve Brown, and I am the CEO of Health Hero Network, a technology company in Mountain View, CA.
We serve people struggling with chronic illness. Our technologies are designed to enable caregivers to coach and monitor patients at home. I am going to talk about some of the commonsense things that Senator Lincoln talked about, and I am also going to talk about some of the programs we are involved with, which hopefully will make the CBO happy about the results as well.
My view is that health care does not start when we are wheeled into the emergency room, and it does not start at the doctor’s office. Health care starts at home, with our own behavior and with prevention.
Most people in Medicare have a chronic illness. For them, prevention means reducing the complications of chronic illness and living independently longer. From our work with the Veterans’ Administration, we have seen that when caregivers and patients work together on daily management and prevention, they can improve the quality of life and reduce costs.
To illustrate this point, I am going to introduce Wally Browning from Huntington, WV, who recently was interviewed in his local paper. I included this in the written testimony.
Wally Browning is a Vietnam veteran. He served our country in Vietnam, and now he is being served by the VA and by Health Hero Network.
Wally has congestive heart failure, one of those high-cost, high-risk conditions that require very close attention and management. It is also one of the leading causes of hospital admissions for Medicare.
Every day a nurse at the VA checks in on how well Wally is doing, remotely, by sending message to a device installed in Wally’s home, called Health Buddy, and I brought that for you to see too.
With simple push buttons, Wally is able to answer questions that appear on the screen and tell his nurse how he is doing; tell his nurse about new symptoms transmit data about his blood pressure and his weight and also get feedback and coaching from his nurse about his condition and about his health program and about healthy choices that he needs to make.
A VA nurse uses a computer with a secure Internet application to analyze Wally’s data every day and flag potential problems before they become worse. The result has been fewer emergencies, fewer stays in the hospital, greater peace of mind, and cost savings for the VA. As Wally puts it, after he checks in with his Health Buddy, he feels like he is good for another day.
Wally is like 20 million Americans with complex chronic illnesses who are at risk of going to the hospital any day. Many of these hospital admissions can be prevented if we coach and monitor patients at home.
The reason our health care system is in trouble, even though we spend nearly $2 trillion a year on it, is that we are not paying for the right model of chronic care. For 40 years, Medicare payment has been based on episodic, face-to-face encounters with a doctor, usually in reaction to a crisis.
But chronic illness is not episodic. It is long-term, and it needs to be managed every day. If we want to prevent hospitalizations, we need to coach and monitor patients at home before a crisis occurs.
We know it is possible because we are doing this every day across America for thousands of veterans. According to the VA, hospital admissions for patients in the program were 63 percent lower than for a comparison group with similar high-riskconditions.
Last year, we worked with the Information Technology Association of America to look at the question. What if Medicare could achieve similar results to the VA with similar patients? The answer published by the ITAA–and that report is also in the written testimony–is that we would save over $30 billion a year.
As a result of your leadership and that of your colleagues, the Medicare Modernization Act starts to recognize that people with complex chronic illness need continuity of care and prevention rather than more episodic crisis management. That is a major step forward for Medicare, and now the challenge is execution.
We are participating in two large-scale chronic care improvement pilots authorized by the Medicare Modernization Act. We are also working with the American Medical Group Association and its physician groups, like the one in Bend, OR, to create a chronic care model based on coaching and monitoring patients at home, under the supervision of their primary physician.
Part of the wisdom of the recent Medicare initiatives is in recognizing how technology can play a vital role in transforming the model of care for chronic illness. Information technologies can extend care into the home and coach patients to improve their own lives and change their own behavior. Caregivers can detect early and deliver the right care at the right time before there is a crisis.
Health care and prevention starts at home, and the right technology can help people struggling with chronic illness and connect them to better care. I thank you for inviting me to testify today.