Junto Profile: Health Recovery Solutions (HRS)
Beginning in Fiscal Year 2013, as part of the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) began instituting financial penalties on hospitals with excessive readmission. This program, called Hospital Readmissions Reduction Program (HRRP), reduces Medicaid and Medicare payments to hospitals who fail to keep patients with Acute Myocardial Infarction (AMI), Chronic Obstructive Pulmonary Disease (COPD), Heart Failure (HF), Coronary Artery Bypass Graft (CABG) Surgery, and Pneumonia out of the hospital for 30 days after their initial visit.
This financial penalty was instated to make hospitals take responsibility for the quality of care provided. With HRRP in place, hospital readmission within a 30-day window has now become expensive and time-consuming issue for hospitals and patients alike. Excessive Readmission Rates (ERR) reduce quality of care across the country.
The digital health company Health Recovery Solutions (HRS) works to reduce hospital readmission rates through technology. Through customized, disease-specific software platforms, in addition to a web portal and phone application, HRS allows clinicians and patients to track, manage, and communicate information surrounding their treatments plans, keeping patients out of the hospital.
We spoke with Jarrett Bauer, CEO & Founder of HRS, to better understand how HRS is revolutionizing at-home care to keep patients from being re-hospitalized. By studying the leading causes of hospital re-admittance, Bauer has designed a variety of technological and data-driven tools that address patient, family member, caretaker, and clinician needs.
Junto Health (JH): What inspired you to create HRS? What is your background prior to founding HRS?
Jarrett Bauer (JB): My connection to HRS is very personal. When I was getting my MBA at Johns Hopkins, my grandmother had been readmitted to the hospital with heart failure. The main reason she had to go back to the hospital was because she wasn’t compliant with her medication. At the time, I remember feeling that she should have had more tools to remain healthy outside of the hospital. I also had wished there was a way that my family could be actively involved with her health, even though she was living down in Florida.
I started looking into the primary drivers of hospital readmission – they were medication noncompliance, diet, and lack of caregiver support. I wanted to create technology that would provide patients with the tools to combat all of this. Thus, HRS was born.
Prior to starting HRS, I worked as a healthcare consultant, after which I went on to receive my MBA at Johns Hopkins. It was while I was at Hopkins that I created a business plan for Health Recovery Solutions.
JH: How does HRS work? Can you explain the various components of HRS?
JB: HRS supplies home care agencies and hospitals with an advanced remote monitoring platform focused on changing patient behavior to reduce hospital readmissions and improve clinical outcomes. Our aim is to offer a telehealth solution that works for all patients, regardless of age, geographical location, or disease state.
We understand that every patient has different needs, so we have developed a three tier approach to telehealth. The HRS platform now consists of three tiers:
PatientConnect Complete: the original HRS solution that includes a tablet and disease specific Bluetooth peripheral devices
PatientConnect Core: a tablet only telehealth solution
PatientConnect Mobile: a downloadable version of the HRS software that patients can use on their own devices.
The three tier approach is supported by HRS’ disease modules, which now include over 30 categories, such as behavioral health, palliative care, smoking cessation, and several new post-surgical care plans.
All of the HRS disease specific engagement kits are customized with educational videos, care plans, medication reminders, with the option of integrating with Bluetooth peripherals to track patients’ blood pressure, weight, heart rate, and more.
For clinicians, the HRS software allows for effective management of high risk patients and provides seamless communication via video chat, wound imaging, and text messaging. Family members can also participate in the monitoring to be fully involved in the care and well being of their loved ones.
HRS also is a cloud based software, which has enhanced our capabilities. Utilizing the cloud was a major advantage right from the beginning as we needed less startup costs. It also allowed us as a smaller company to compete with larger companies in the space. Additionally, the cloud facilitates easier technological expansion that we can quickly roll out to our clients.
JH: Why did you decide to focus on developing a solution to address high readmission rates?
JB: After my experience with my grandmother, I started looking into the primary drivers of hospital readmission. I found that the main culprits were medication non-compliance, diet, and lack of caregiver support. I wanted to create something that would give patients and their families the tools to mitigate these causes of readmission.
My motivation to create HRS was bolstered after I found a line in the Affordable Care Act that stated hospitals would be penalized for readmissions. It was a perfect set up – this was something I was passionate about was also responding to a new need within the medical system.
JH: How did you go about gathering market research and developing a product that would effectively address concerns across a diverse set of health systems?
JB: I knew our product had to solve a problem. There was the problem of patients not having the tools to be successful and there was the emerging problem of hospitals being held accountable for readmission rates. Healthcare was changing, and providers were being forced to find a solution to lower readmission rates. When I saw that, I knew this product would work.
We did a research study to ensure our initial launch was effective. We conducted a study with one of our first clients to evaluate the impact of using remote patient monitoring with heart failure patients. The study found that patients utilizing HRS had an 8% readmission rate compared with a 28% readmission rate for patients who did not receive a tablet. This data was important – it solidified the fact that what we were doing at HRS was effective. We were engaging patients and simultaneously taking cost out of the system.
Our research and progress are ever evolving. Our recent launch of a three tier approach is rooted in us recognizing the growing needs of the healthcare system. Our complete, tablet, and mobile options allow us to be a flexible provider that can offer care to all different kinds of patients.
JH: How many users does HRS have?
JB: Since the inception of HRS, we have monitored 40,000 high risk patients. We are in 100 medical centers, including Mass General, UPenn, Northwell Health, and Catholic Health system. We have a national presence, but we are always looking to expand. Right now, we are focused on reaching new patient populations with our three tier approach, such as behavioral health patients, palliative care patients, and long term chronic care management patients.
JH: What are the most prevalent chronic medical conditions among HRS users? How have you designed HRS for the specific needs of these prevalent chronic conditions?
JB: HRS started out primarily treating patients with CHF, COPD, and Diabetes, but as we have grown, we have adapted our technology to be used among a much more diverse patient population. Behavioral health patients can use our tablet only and mobile approaches, as can palliative care patients.
We know that healthcare is not one size fits all, so at HRS we aim to customize our options to provide personalized care to all of our patients. We currently have over 30 disease modules that allow HRS users to create customized care plans for a wide variety of patients.
JH: What is your current pricing and reimbursement model?
JB: Pricing is determined by the tier. Our complete model is our most expensive option, while our core and mobile options offer lower cost alternatives. Some providers also view our tiers as a care continuum, where patients use each tier as a gradual path to independence. By implementing all three tiers, some of our clients are able to serve more patients while keeping costs manageable.
At this time, Medicare/Medicaid reimbursement for telehealth is a work in progress. While there are several scenarios where telehealth can be reimbursed, that is not the case across the board. As a company, we are actively involved in writing to our representatives and advocating for widespread telehealth reimbursement.
JH: What feedback have you received from the medical community and from HRS users?
JB: Overall, we hear that our product helps increase efficiency for the medical community. We have also had many users be pleasantly surprised that telehealth technology allows them to increase touch points with their patients. A common objection to telehealth is the fear that the technology will remove healthcare’s personal touch, but many users have reported the opposite. With video conferencing and text messaging, clinicians are actually able to keep in better touch with patients and provide peace of mind that a clinician is always readily available.
JH: What are the next 3 major milestones for HRS?
JB: Our next three milestones are to:
Grow our company to 100 people – we want to keep recruiting talent that will help us create a better product and reach more people with our message.
Reach 100,000 patients monitored.
Develop predictive analytics to help every HRS user objectively understand a patient’s medical trajectory.