Aedan Enriquez3, Maya J. Dhond1, Yardana Gill1, Milind Dhond2, 1, Cyrus Mancherje1, Jeff Breneisen1, Hossein Dehghani1, Terra Hadsall1. 1Cardiology, Northbay Healthcare, Fairfield, California, United States, 2UC Davis, Davis, California, United States, 3UC Berkeley, Berkeley, California, United States
Purpose of Study
Congestive heart failure (CHF) healthcare costs exceed $30 billion annually in the United States. We used Kencor Artificial Intelligence Software (KAIS) to evaluate the reduction in CHF-associated costs to Medicare.
We enrolled 30 patients from our CHF(systolic and diastolic) clinic in KAIS. KAIS was downloaded to patients’ smartphones with on-site training. Patients were provided with Wifi-enabled blood pressure (BP) cuff, weight scale, and pulse oximeter. Patients completed the daily 5-minute program with the transmission of data to the clinic. KAIS stratified the patients into low (green), medium (yellow), or high (red) risk for admission. High-risk patients were contacted by the CHF nurse or seen in the clinic. We collected data 6 months pre and post KAIS enrollment. We assigned a $13,000 cost to Medicare for each CHF hospital admission. We assigned a $59 cost per patient per month (pppm) to Medicare to implement KAIS using the current procedural terminology (CPT) code 99091. This cost was added to the monthly cost to Medicare post KAIS enrollment. By calculating the cost of CHF admissions pppm we obtained the net cost to Medicare pre and post KAIS enrollment.
29/30 (97%) were compliant with KAIS. The patients (16 women) were aged 44-88 years (average: 63.8 years). The average ejection fraction (EF) was 41.5%. The pre-enrollment CHF admission rate was 0.128/month (203 months total). The post-enrollment CHF admission rate was 0.077/month (155 months total). There was a 40% reduction in the admission rate per month per patient (p=0.03). The pre and post KAIS enrollment hospital costs to Medicare pppm were $1665.02 and $1006.45 respectively. The cost pppm to Medicare of implementing KAIS was $59. After adding that to the post-enrollment cost, the saving pppm was $599.97. The annual reduction in total Medicare costs amounts to $7194.88 per patient.
In a small pilot study of outpatients with CHF, enrollment in KAIS reduced CHF hospital admissions by 40%. This led to an annual reduction in Medicare costs of $7194.88 per patient. Implementation of KAIS may lead to significant cost savings to Medicare in CHF populations.