The Ceresti Digital Care Management Program (DCMP) is optimized to proactively avoid unnecessary hospitalizations for high risk member who are reliant on family caregivers. Ideally, these member/caregiver dyads are already enrolled in Ceresti’s Family Caregiver Empowerment Program (FCEP) as a supplemental Medicare Advantage benefit.
Ceresti can identify high-risk dyads based on our proprietary analysis of member claims data and our prior assessments of caregiver’s strengths and weaknesses. High-risk dyads who are enrolled in the Ceresti’s DCMP are more actively and extensively monitored than those in the FCEP. Actionable alerts are also managed more diligently.
Preventing avoidable hospitalizations reduces members’ healthcare costs as well as caregivers’ burden. It also reduces the cognitive and functional declines that are associated with members’ experiences of hospitalizations and other acute events.
Focus on High Risk Members Who Rely on Family Caregivers
Focusing on the 30% of members who are unable to effectively self-manage their health; i.e., those who rely on family caregivers, represents a significant opportunity for reducing healthcare costs. Claims analysis highlights that these members incur approximately 65% of all hospitalizations in a Medicare Advantage health plan, a 2-3x multiple when compared to members who are able to self-manage their health.
We estimate that a robust implementation of the Ceresti Digital Care Management Program (DCMP) can potentially reduce hospitalizations incurred by members who rely on a family caregiver by 20-30%. Outcomes from limited enrollment pragmatic trials suggest that this level of costs savings is achievable. Assuming that 25% of these members enroll in Ceresti’s DCIM, the potential reduction in total healthcare costs attributable to Ceresti’s DCMP is 3-5%.
Focusing on Dementia Can Reduce Total Healthcare Costs by 1-2%
The chart below illustrates the cost multiplier for dementia, a condition that on its own drives 25% of all hospitalizations. Under the assumptions detailed above, the potential reduction in total healthcare costs attributable to Ceresti’s DCMP for members with dementia is 1-2%.