IMPROVED SURVIVAL WITH TELEPHONIC CARE MANAGEMENT

Purpose: Humana Cares/SeniorBridge offers a confidential telephonic care management program to improve health outcomes of people with chronic conditions. The purpose of this study was to examine the impact of that care management program on survival rates over 2 years.

Method: This retrospective cohort study used administrative claims from individuals enrolled in a Humana Medicare Advantage plan between January 1, 2011 and December 31, 2012. Individuals at high risk for disease progression were identified by predictive models and invited to participate in the care management program. The care management program assigns care managers to monitor and provide recommendations to participants through telephonic care management. For this study, individuals who participated in the care management program formed the participant group, and those who were referred to the program but did not participate formed the control group. The participant and control groups were propensity score matched 1:1 using the following variables: CMS Medicare Advantage risk score, an internal risk score, geographic region, Medicare Advantage plan type, age, and gender.  Kaplan-Meier curves were used to estimate cumulative survival over time, allowing for right censoring when individuals left the health plan or changed program participation status. Arithmetic differences in survival rates between the participants and control groups were assessed overall and in subgroups of age and gender.

Result: The study sample included 57,041 people with a mean age of 71 years and 55.0% female. Participants had higher survival rates (87.4%) than the controls (84.6%) at 2 years (P<0.001). Differences in survival rates increased over time from 1.5% at 6 months, to 2.3% at 1 year, to 2.8% at 2 years. The difference in 2-year survival rates was highest (difference=7.8%, 80.4% participants and 72.5% controls, P<0.001) in the >80 years age group compared to other age groups. The difference in 2-year survival rates was slightly higher (3.6%) among females than males (3.1%).

Conclusion: In this Medicare Advantage population, participants who participated in Humana Cares/SeniorBridge care management program had higher survival rates than those who did not participate, and the magnitude of the impact increased over time. This information is the first of its kind in the area of telephonic care management and may assist policymakers in identifying, designing and implementing strategies to provide individuals with chronic conditions access to appropriate care management.