Optimized for ROI by enrolling caregivers of Members with caregiver-supported conditions
CARE MANAGEMENT FLYER
Members Who Depend on Caregivers Drive More Than 50% of Total Healthcare Costs
26% of Members in a typical Medicare Advantage plan depend on family caregivers (e.g., spouses, adult children) to manage their care. These underserved Members rely on family caregivers to access care, benefits and programs, and are difficult to engage in traditional care management programs.
Members who depend on Caregivers can be identified based on having conditions that require high levels of caregiver support (e.g., dementia, stroke, Parkinson’s disease, and frailty). Collectively, Members with at least one of these conditions drive 56% of total costs for a Medicare Advantage plan; more for a Duals plan.
Sources: Milliman white paper, J Am Geriatrics Soc. 2015 June; 63(6):1121-1128, Ceresti claims analyses
Digital Caregiver Empowerment Platform
Purpose-built to make it easy for payers/providers to support Members who depend on family caregivers
Our platform supports the following capabilities:
Platform Capabilities
The key elements of our approach to virtual care are education, coaching and remote monitoring.
Virtual Care Enabled by Family Caregivers
Caregivers receive a dedicated elder-friendly tablet, or download an app, that enables access to a program of personalized education, evidence-based support, remote risk assessments and proactive coaching.
Improve caregiver effectiveness via education and coaching
Caregivers engage in personalized education to learn how to:
- manage their loved one’s chronic conditions
- address psychosocial needs
- increase family support and connectedness
- identify community-based organizations.
Mobile platform enables caregiver engagement in education, support, risk assessments and digital therapies
Experienced coaches proactively engage, monitor and support caregivers
Evidence-based medical and psychosocial content (e.g., videos, tutorials) is curated to support caregivers
Reduce Member Hospitalizations via Remote Monitoring
We train and support family caregivers to detect the signs and symptoms of emerging health issues in the Member, and engage them in remote risk assessments (informed by predictive analytics) to monitor the Member’s health.
Ceresti coaches manage or refer actionable alerts to prevent the need for an emergency department visit or a hospitalization.
Predictive Risk Assessments Enable Better Outcomes
We use claims and other data sources to risk-stratify Members based on their likelihood of an emergency department visit or a hospitalization. We predict the most likely underlying causes (e.g., dehydration, hypertension, medication side effect) for such an acute event (e.g., fall, stroke, infection) and use this information to drive Member-specific risk assessments that are specifically aimed at identifying the early warning signs of issues that could lead to a preventable hospitalization. In parallel, we train the family caregiver to look for specific signs and symptoms in the Member, which may include asking the caregiver to report specific biometrics (e.g., blood pressure, weight, etc.).
The ability to secure multiple risk assessments every week about Members, via their caregivers, is enabled by high levels of caregiver engagement (40 minutes per week) that we achieve using a combination of education, support and remote coaching.
Leave Enrollment to Us
Health plans don’t always know who the family caregivers are for their Members.
Ceresti can take the lead in driving caregiver/Member enrollment. We use a multi-dimensional approach that includes direct-to-Member outreach, outreach to caregivers, referrals, and, if available, targeting using claims data. We have established proven processes for obtaining Member (or proxy) consent, and gaining acceptance of program terms and conditions from the family caregiver.
Tech-Only Option
Our modular technology-based platform supports multiple deployment option. For example, we can provide a “technology-only” solution that is staffed by payer/provider coaches that we can train and support.