MaineHealth ACO Case Study

Download the Case Study
×

Overview

MaineHealth Accountable Care Organization Partners with Anthem to Reduce Healthcare Utilization for Hypertension Patients

MaineHealth Accountable Care Organization (MHACO) is a network of 11 hospitals, 347 medical practices, and over 1,700 providers across Maine and New Hampshire. With the goal of increasing care quality and value to patients, MHACO negotiates care costs with insurers, engages and supports providers, and develops innovative care programs to enhance patient care.

Challenge

According to the Centers for Disease Control and Prevention (CDC), over 100 million Americans suffer from hypertension, a condition that places extra strain on a person’s blood vessels, heart, and kidneys. Healthcare services, medications, and loss of productivity related to hypertension cost the US between $131 and $198 billion each year over the last decade. The costs associated with hypertension have risen over the last decade, as hypertension continues to go undiagnosed or untreated by many Americans.

As of 2020, the CDC noted only 1 in 4 hypertension patients have their condition under control. The high rate of uncontrolled hypertension is largely due to several factors:

blood_pressure_icon

Low patient adherence to hypertension medication regimens, therapies, and care plans.

Patient Engagement

Complexity of care plans and lack of education on the impact of uncontrolled hypertension and benefits of care.

Conversation

Poor patient–physician communication delaying enrollment in hypertension therapies, or preventing timely intervention or escalation of care services.

Solution

In early 2021, MHACO partnered with Anthem to reduce healthcare utilization among patients diagnosed with hypertension. The pilot program sought to establish telehealth and remote patient monitoring as a viable means for educating patients on the symptoms and treatments of hypertension and for reducing emergency department visits and hospital admissions.

Working with Western Maine Primary Care and Mid Coast Medical Group, MHACO enrolled patients with uncontrolled hypertension or a history of hospitalization due to hypertension. In addition to providing oversight and improving education, the MHACO program aimed to build long term engagement among hypertension patients in their care plan to enhance patients’ overall quality of life.  

Telehealth and RPM Enabled MHACO Clinicians to Enhance Patient Care by Providing:

  • Daily vital sign monitoring of patients’ blood pressure readings, recorded by patients on a tablet and seamlessly transferred to a clinician dashboard.

  • Condition-specific symptom surveys answered daily by patients to provide a complete picture of patients’ daily health status to the MHACO care team. 

  • Education and clinician interventions, when deemed necessary by the MHACO care team or when vital signs and reported symptoms triggered a high-risk alert, indicating a potential exacerbation.

  • Enhanced care coordination through weekly patient reports provided to referring physicians, highlighting any clinical interventions, medication changes, and care plan modifications that were made by the MHACO care team.

Of Telehealth Patients Achieved Controlled Hypertension Status within Four Weeks

Results

Patients with uncontrolled hypertension were enrolled in the MHACO pilot program for a minimum of six weeks, providing them with access to clinical monitoring and educational content as they adjusted to their new care plan and lifestyle changes.

Within four weeks of enrollment in the telehealth and RPM pilot program, 70% of patients had controlled their hypertension, achieving consistent, daily blood pressure readings at the 135/85 control threshold.